难治性功能性消化不良患者的饮食行为研究

Analysis of the eating behaviors associated with refractory functional dyspepsia

目的探讨难治性功能性消化不良患者的饮食行为。方法采用多中心、前瞻性调查设计。研究对象取自2012年5～9月广东省3家三甲医院消化专科门诊就诊的符合罗马Ⅲ标准的1341例功能性消化不良（functional dyspepsia，FD）患者和100例健康志愿者，通过问卷调查其饮食行为，并进行Logistic回归分析。结果①难治性FD约占FD的24．4％。②与健康对照组相比，难治组和非难治组存在较高的饮食行为异常和饮食偏爱；其中难治组在跳餐、加餐、偏爱甜食和产气食物等方面表现最为突出（均P〈0．05）。③与非难治性FD相比，难治性FD的EPS（上腹痛综合征）存在偏爱辛辣食物的现象（47．5％，35．7％，P〈0．05），PDS（餐后不适综合征）则偏爱甜食（50．0％，36．4％，P〈0．05）和产气食物（14．9％，7．1％，P〈0．05），而混合型（EPS＋PDS）存在跳餐（30．1％，17．0％，P〈0．05）、加餐（15．0％，6．5％，P〈0．05）的现象。@Logistic回归分析显示跳餐（95％CI，1．177—2．272；P=0．003）、加餐（95％CI，1．015～2．604；P=0．043）、偏爱甜食（95％CI，1．040—1．757；P=0．024）和产气食物（95％CI，1．022～2．306；P=0．039）是难治性FD的危险因素。结论难治性FD患者多存在异常饮食行为，其中跳餐、加餐、偏爱甜食和产气食物等是其“难治”的重要原因。

Objective To explore the eating behaviors associated with refractory functional dyspepsia （RFD）. Methods In this muhicenter, prospective trial, 1341 new outpatients with functional dyspepsia （FD） from three Guangdong hospitals who had been diagnosed according to the Rome III criteria were enrolled from May to September in 2012. One hundred healthy volunteers were also enrolled as controls. A questionnaire was used to obtain data,and logistic regression analysis was used for analysis. Results ①RFD was diagnosed in 24.4% of the FD patients.②Unheahhy eating behaviors were significantly greater in patients with RFD and non-RFD than in the normal controls. Patients with RFD skipped meals more often, ate extra meals, and preferred sweets and gasproducing foods （ P〈 0.05 ）. ③A comparison among the non-RFD subtypes, showed that those with epigastric pain syndrome had a greater preference for spicy foods （47.5 % vs 35.7 % , P 〈 0.05 ） , and those with postprandial distress syndrome had a greater preference for sweets（50.0% vs 36.4%, P〈0.05） and gas-producing foods （14.9% vs 7.1%, P 〈0.05）. Those with both subtypes skipped more meals （30.1% vs 17.0%, P 〈 0.05 ）, and ate extra meals （ 15.0% vs 6.5% , P 〈 O. 05 ）. ④Logistic regression analysis showed that meal skipping （95% CI , 1. 177 2.272; P= 0. 003） , eating extra meals （95% CI , 1. 015 - 2. 604; P = 0.043） , and a preference for sweets （ 95 % CI, 1. 040 - 1. 757 ; P = 0. 024） and gas-producing foods （ 95 % CI, 1. 022 - 2. 306 ; P = 0. 039 ） were risk factors for RFD. Conclusion Unhealthy eating behaviors, especially, meal skipping, eating extra meals, preferring sweets and gas-producing foods correlate with RFD and these behaviors may be the key reasons for the refractory characteristic of RFD.