功能性胃肠病患者临床症状与抑郁焦虑关系

Relationship between clinical symptoms and depression and anxiety in functional gastrointestinal disorders patients

人群中功能性胃肠病(functional gastrointestinal disorders, FGIDs)约占40%,表现为长期反复的腹痛、腹饱、嗳气、便秘,无法用器质性损伤或是生化异常解释,包括肠易激综合征、功能性消化不良、功能性便秘。过去20年国内外前沿研究揭示了心理精神因素与FGIDs的相关性,提出“脑-肠轴”为其重要的病理生理机制。心理因素与FGIDs是因果关系还是附带关系一直存在争议,究竟是脑-肠(心理困扰先于消化道症状)或是肠-脑(消化道症状首先开始)通路。本综述根据国内外研究,总结心理精神因素与FGIDs的联系。

About 40%of the population suffer from functional gastrointestinal disorders(FGIDs),presenting long-term recurrent abdominal pain,abdominal bloating,abdominal distension,repetitive eructation and constipation,which could not be explained by organic injury or biochemical abnormalities,including irritable bowel syndrome,functional dyspepsia and functional constipation.In the past 20 years,the latest research at home and abroad has revealed the correlation between psychological factors and FGIDs,the brain-gut axis is proposed as an important pathophysiological mechanism.Whether psychological factors are causal or incidental in FGIDs has remained controversial,predominance of brain-gut(where psychological distress precedes gastrointestinal tract symptoms)versus gut-brain origins(where gastrointestinal tract symptoms begin first).Based on studies,this review summarized the relationship between psychological factors and FGIDs.