Objective:To investigate the therapeutic effect of Biling Weitong Granules combined with oryz-aspergillus enzyme and pancreatin tablets on patients with reflux esophagitis with functional dyspepsia.Methods:Sixty patie...Objective:To investigate the therapeutic effect of Biling Weitong Granules combined with oryz-aspergillus enzyme and pancreatin tablets on patients with reflux esophagitis with functional dyspepsia.Methods:Sixty patients diagnosed with reflux esophagitis with functional dyspepsia who were admitted to the Affiliated Hospital of Hebei University between June 2020 and June 2023 were selected and divided into two groups:the control group and the observation group,each consisting of 30 cases.The control group received oryz-aspergillus enzyme and pancreatin tablets only,while the observation group received Biling Weitong Granules in addition to the tablets.The clinical efficacy,Chinese medicine syndrome points,esophageal kinetic indexes,gastrointestinal hormone levels,and therapeutic safety of both groups were evaluated.Results:The total efficiency of the observation group reached 93.33%,significantly higher than the 73.33%of the control group(P<0.05).After treatment,patients in the observation group exhibited significantly lower scores for Chinese medicine symptoms such as early satiety,belching,abdominal distension,abdominal pain,and loss of appetite compared to the control group(P<0.05).Furthermore,the observation group showed significantly higher upper esophageal sphincter pressure,lower esophageal sphincter pressure,and distal esophageal contraction scores compared to the control group(P<0.05).Additionally,levels of gastric motility hormone,vasoactive intestinal peptide,and gastrin were significantly higher in the observation group compared to the control group(P<0.05).Throughout the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups,indicating comparable safety of the two treatment modalities(P>0.05).Conclusion:The combination of Biling Weitong Granules with oryz-aspergillus enzyme and pancreatin tablets demonstrates significant efficacy in the treatment of reflux esophagitis with functional dyspepsia,with a better safety profile.This finding warrants further clinical promotion.展开更多
Objective:To explore the main acupoint prescription and mechanism of acupuncture in treating Functional dyspepsia(FD)by analyzing the clinical randomized controlled trial literature on acupoints and targets of acupunc...Objective:To explore the main acupoint prescription and mechanism of acupuncture in treating Functional dyspepsia(FD)by analyzing the clinical randomized controlled trial literature on acupoints and targets of acupuncture in the treatment of FD combined with association rule mining and bioinformatics/network pharmacology methods.Methods:Search relevant clinical randomized controlled trial literature on acupoints and therapeutic targets of acupuncture in the treatment of FD from eight databases from their inception to June 18th,2022.We obtained acupuncture selection points,meridian,and therapeutic targets and established acupoints database for acupuncture treatment of FD.FD-related targets were collected from GeneCards,DisGeNET,OMIM,and DrugBank databases.We obtained the potential targets of acupuncture on FD by taking the intersection of acupuncture for FD therapeutic targets and FD-related targets.We performed the protein-protein interaction network,Gene Ontology(GO)analysis,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Results:In this study,26 Randomized Controlled Trials related to acupuncture treatment of FD were retrieved.We obtained 29 acupoints,17 acupuncture for FD therapeutic targets,and 10 intersection targets.Tumor necrosis factor(TNF),Interleukin(IL)-1,and Neuropeptide Y(NPY)are key targets of acupuncture in the treatment of FD.Conclusion:ST36-CV12-PC6-LR3 is the main acupoint prescription for FD.Acupuncture may affect Neuroactive ligand-receptor interaction,Gastric acid secretion,and IL-17,TNF signaling pathways by regulating related key targets,and play a synergistic role in the treatment of FD by inhibiting gastric acid secretion,alleviating inflammatory response,regulating the brain-gut axis,improving mood and other aspects.展开更多
AIM: To investigate whether there were symptom-based tendencies in the Helicobacter pylori (H. pylori) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study o...AIM: To investigate whether there were symptom-based tendencies in the Helicobacter pylori (H. pylori) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conduct- ed. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching,epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 46%, 36%, 52.5% and 33.3%, respectively, and there was no significant difference from the placebo group (39.3%, 27.1%, 39.1% and 31.4%) (P > 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belch- ing were 41.4%, 33.3%, 50% and 31.4%, respective- ly, and did not differ from those in the placebo group (P > 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 34.8%, 27.9%, 41.1% and 26.7% respectively in the treatment group, with no significant difference from those in the placebo group (34.8%, 23.9%, 35.3% and 27.1%) (P > 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.展开更多
AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were...AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were included in this study.One week after single-blinded placebo run-in treatment,baseline nocturnal intragastric pH,bile reflux and nocturnal dyspeptic symptoms of eligible patients,including epigastric pain or discomfort,abdominal distention and belching, were investigated with questionnaires.Patients exhibiting nocturnal dyspeptic symptoms were randomly and double-blindly assigned to domperidone group or placebo group.Nocturnal intragastric pH and percentage of duodenogastric bile reflux time were determined after treatment. RESULTS:Of the 85 FD patients,2 females withoutnocturnal symptoms,who responded to placebo run-in treatment,were excluded from the study,30(36.1%) exhibited nocturnal dyspeptic symptoms with increased duodenogastric bile reflux time(intragastric bilirubin absorbance>0.14)and mean gastric pH(confirming the existence of bile reflux)(P=0.021,0.023) at night were included in the study.Of these 30 patients,21(70%)had overt nocturnal duodenogastric bile reflux,which was significantly higher than that of those without nocturnal symptoms(P=0.026).The 30 patients were allocated to domperidone group or placebo group(n=15).The nocturnal duodenogastric bile reflux and gastric pH were significantly decreased after domperidone treatment(P=0.015,0.021).The severity score of nocturnal dyspeptic symptoms was also significantly decreased after domperidone treatment (P=0.010,0.015,0.026),which was positively correlated with the reduced nocturnal bile reflux or gastric pH(r=0.736,0.784,0.753 or r=0.679,0.715,0.697, P=0.039,0.036,0.037 or P=0.043,0.039,0.040). CONCLUSION:A subgroup of Chinese FD patients show overt nocturnal dyspeptic symptoms,which may be correlated with the excessive nocturnal duodenogastric bile reflux.Domperidone therapy can alleviate these symptoms.展开更多
Hypervigilance and symptoms anticipation,visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia(FD)patients.Many patients recognize...Hypervigilance and symptoms anticipation,visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia(FD)patients.Many patients recognize meals as the main triggering factor;thus,dietary manipulations often represent the first-line management strategy in this cohort of patients.Nonetheless,scarce quality evidence has been produced regarding the relationship between specific foods and/or macronutrients and the onset of FD symptoms,resulting in nonstandardized nutritional approaches.Most dietary advises are indeed empirical and often lead to exclusion diets,reinforcing in patients the perception of“being intolerant”to food and self-perpetuating some of the very mechanisms underlying dyspepsia physiopathology(i.e.,hypervigilance and symptom anticipation).Clinicians are often uncertain regarding the contribution of specific foods to dyspepsia physiopathology and dedicated professionals(i.e.,dietitians)are only available in tertiary referral settings.This in turn,can result in nutritionally unbalanced diets and could even encourage restrictive eating behaviors in severe dyspepsia.In this review,we aim at evaluating the relationship between dietary habits,macronutrients and specific foods in determining FD symptoms.We will provide an overview of the evidence-based nutritional approach that should be pursued in these patients,providing clinicians with a valuable tool in standardizing nutritional advises and discouraging patients from engaging into indiscriminate food exclusions.展开更多
BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for ...BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for patients with FD.However,there is still a lack of systematic reviews that have analyzed current clinical trials for a better understanding of mechanisms involved in the ameliorating effect of acupuncture and EA on FD.AIM To evaluate the results and qualities of existing clinical evidence for researching the underlying mechanisms of acupuncture/EA in treating FD.METHODS A systematic search of the literature was performed to identify randomized controlled trials in which research on the mechanism of acupuncture or EA was conducted in FD patients.Databases searched included PubMed,EMBASE,Cochrane Library,and Web of Science.Data extraction and quality assessment were completed by two investigators independently and the results of quality evaluation were exported through Review Manager V5.3.RESULTS Eight studies were included in this review with a total of 17 items for detecting techniques for mechanistic research.Positive effects of acupuncture and EA were observed in regulating gastric motility,gastric accommodation,mental status,gastrointestinal hormones,and central and autonomic functions while improving dyspeptic symptoms and quality of life.CONCLUSION The key findings of this systematic review support the potential of acupuncture and EA in altering the heterogeneous pathophysiology in patients with FD.However,high-quality studies with well-planned designs are necessary to provide more credible evidence.展开更多
Objective:To evaluate the efficacy and safety of Chinese herbal medicine(CHM)for the treatment of functional dyspepsia(FD).Methods:Web of Science,PubMed,EMBASE,Cochrane Library,and four other Chinese electronic databa...Objective:To evaluate the efficacy and safety of Chinese herbal medicine(CHM)for the treatment of functional dyspepsia(FD).Methods:Web of Science,PubMed,EMBASE,Cochrane Library,and four other Chinese electronic databases,including China National Knowledge Infrastructure(CNKI),Chinese Biological Medical Database(CBM),Chinese Scientific Journals Database(VIP),and WanFang Database were used to search(up to Feb,2016)for randomized,double-blind,placebocontrolled trials recruiting adults with FD treated with CHM.Study selection,data extraction,quality assessment,and data analyses were conducted based on Cochrane standards using Review Manager software.Results:Fourteen publications(1424 patients)were included.Evidence revealed that CHM was more efficacious than the placebo in improving global dyspepsia symptoms(RR,1.45;95%CI,1.31e1.60),Chinese medicine syndrome(CMS)(RR,1.36;95%CI,1.23e1.50),and quality of life(SMD,0.30;95%CI,0.15e0.45)in FD patients.Furthermore,the difference in the incidence of adverse events between CHM and placebo groups had no statistical significance(RR,1.06;95%CI,0.66e1.70).Conclusion:This meta-analysis demonstrates that CHM has a therapeutic potential in treating FD with a certain safety.However,due to the restricted number of trials included,wellplanned,long-term studies are necessary to provide credible evidence.展开更多
Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats wit...Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats with FD were isolated,cultured,and then divided into six groups as follows:control,model,domperidone,low-dose XSLJZD(LXSLJZD),medium-dose XSLJZD(MXSLJZD),and high-dose XSLJZD(HXSLJZD).Each group was administered the corresponding drug serum for intervention.Drug serum intervention conditions and proliferative activity of SMCs were tested by cholecystokinin octapeptide.Ghrelin,gastrin,somatostatin,and substance P(SP)levels were measured by ELISA.Somatostatin and SP mRNA expression was measured by real-time PCR.Results:A concentration of 10%drug serum for 24 h was decided to be the best intervention condition for later study.The mean optical density value in the model group was lower than that in the control group(P紏.001).Optical density values in the domperidone and HXSLJZD groups were higher than those in the model group(P?.025,P?.032,respectively).Gastrin,SP,and ghrelin levels in the model group were lower(P?.007,P?.037,P?.005,respectively),but somatostatin levels were higher,compared with those in the control group(P?.031).Gastrin,SP,and ghrelin levels in the domperidone,MXSLJZD,and HXSLJZD groups were higher than those in the model group(all P<.05).Somatostatin levels in the four drug-treated groups were lower than those in the model group(P?.002,P?.007,P?.001,P?.009,respectively).SP mRNA levels in the model group were lower than those in the control,domperidone,MXSLJZD,and HXSLJZD groups(P?.037 P?.016,P?.025,P?.002,respectively).Somatostatin mRNA levels in the model group were higher than those in the control and MXSLJZD groups(P紏.042,P紏.035).Conclusions:XSLJZD and domperidone drug serum effectively promote proliferative activity of gastric antrum SMCs in an FD model.The mechanism of this activity may be regulated by gastrointestinal hormones.展开更多
Objective:Based on data mining software,applying frequent itemsets,association rules,hierarchical clustering,complex networks and other data mining methods to analyze the usage and compatibility of traditional Chinese...Objective:Based on data mining software,applying frequent itemsets,association rules,hierarchical clustering,complex networks and other data mining methods to analyze the usage and compatibility of traditional Chinese medicine(TCM)patent compound for functional dyspepsia.Method:Use the Chinese patent database to search the compound for the treatment of functional dyspepsia,exclude traditional Chinese medicine extracts,single drugs,combined use of Chinese and Western medicines,etc.,screen the patented compound of TCM,establish an Excel data table,and apply data mining software to The data is subjected to frequency statistics,association rules,cluster analysis and complex network analysis.Result:A total of 238 prescriptions for functional dyspepsia were screened.The four qi of the drugs were mainly warm and calm,the five flavors were mainly sweet and spicy,and the spleen and stomach were the main meridians.The top 10 Chinese medicines with higher frequency are Shanzha、Chenpi、Gancao、Maiya、Jineijin、Fuling、Baizhu、Shenqu、Houpo、Banxia;frequent itemsets show that the drugs are mainly compatible with qi and spleen,qi and digestion;association rules The analysis shows that the common drug pairs used in the treatment of functional dyspepsia include Chenpi-Shanzha、Maiya-Shanzha、Jineijin-Shanzha,etc.;cluster analysis found that there are 4 types of drugs for functional dyspepsia,mainly including drugs for regulating qi-flowing for harmonizing stomach,drugs for soothing liver and promoting Qi,drugs for eliminating food and resolving accumulation,drugs for benefiting qi and strengthening spleen;the 22-flavor Chinese medicine in the core drug network,the core compatibility is mainly to eliminate stagnation and spleen.Conclusion:Data mining research provides a reference for the clinical treatment of functional dyspepsia and the development of TCM formulas;Clinical treatment of functional dyspepsia should grasp the basic principles of strengthening vital energy and eliminating pathogenic factors to benefit qi,strengthen the spleen,and eliminate food.It is a basic treatment method,taking into account the methods of regulating qi-flowing for harmonizing stomach,soothing the liver and relieving depression,relieving dampness and dampness,and combining the specific conditions of patients with syndrome differentiation and treatment.展开更多
BACKGROUND: It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental ...BACKGROUND: It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental factors can lead to excessive gastrointestinal consensual reaction, and result in different brain-gut axis disturbance, and then cause the gastrointestinal sensorimotor abnormality and endocrine changes.OBJECTIVE: To observe the effect of antidepressant treatment on the changes of water load and serum cortisol in patients with functional dyspepsia, and analyze the therapeutic mechanism.DESIGN: A comparative observation.SETTING: The First Affiliated Hospital o Zhengzhou University.PARTICIPANTS: Forty-five patients with functional dyspepsia accompanied by depression were selected from the Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University from July 2004 to July 2006, and they were 25 - 65 years of age, and their disease courses ranged 1 - 10 years. They were all accorded with the diagnostic standards for Rome Ⅱ functional dyspepsia functional dyspepsia. As the patients' will, they were divided into treatment group (n =30, 12 males and 18 females) and control group (n =15, 6 males and 9 females), and there were no significant differences in the data between the two groups (P 〉 0.05). The programs were discussed and agreed by the committee of medical ethics of the First Affiliated Hospital of Zhengzhou University. Informed contents were obtained from all the patients.METHODS: In the treatment group, the patients were treated with venlafaxine sustained release capsule (75 mg per day), and those with sleep disorder were added by benzodiazepines (alprazolam). In the control group, the patients were given routine treatments of antacid, prokinetics, etc. Before and after 8-week treatment, the following examinations were performed: ① The gastrointestinal symptoms were assessed according to the symptoms; ② The severity of depression was evaluated with Hamilton depression scale (HAMD); ③The relaxation of proximal stomach was observed using water load test; ④ The serum level of cortisol was detected.MAIN OUTCOME MEASURES: ① Symptom score; ② HAMD score; ③ Water load amount; ④Serum level of cortisol.RESULTS: All the 45 patients were involved in the analysis of results. ① Symptom score: The scores of gastrointestinal symptoms were decreased as compared with those before treatment in both the treatment group and control group (P 〈 0.05). ② HAMD scores: The scores of HAMD were decreased as compared with those before treatment in both the treatment group and control group (P 〈 0.05). ③ Water load amount:The total effective rate was significantly higher in the treatment group than the control group (P 〈 0.05). ④The serum levels of cortisol after treatment were significantly lower than those before treatment in the patients with severe gastrointestinal symptoms in the treatment group and control group (P 〈 0.05).CONCLUSION: Antidepressants can normalize the cortisol level of patients with functional dyspepsia, and then decrease gastric sensitivity and ameliorates the receptive relaxation of proximal stomach, also increase the water load amount correspondingly, and finally control the gastrointestinal symptoms of functional dyspepsia.展开更多
BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has...BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has been described in Ob after sleeve gastrectomy(SG).Hedonic response to a meal is dissociable from satiation in healthy subjects.Anhedonia is the lowered ability to experience pleasure.There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.AIM To assess the relationship among anhedonia,BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.METHODS Eighty-one Ob without SG,45 Ob with SG and 55 healthy controls(HC)were studied.All subjects fulfilled the binge eating scale(BES)to investigate BED,the validated 14 items Snaith-Hamilton pleasure scale(SHAPS)to assess Anhedonia as well as the Beck Depression Inventory-II(BDI II)and State Trait Anxiety Inventory(STAI)questionnaires to screen for depression and anxiety.All patients underwent a standardized questionnaire investigating the intensity-frequency scores(0-6)of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia(FD)and its subtypes according to ROME IV criteria.RESULTS Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED(OR:4.7;95.0%CI 1.23-18.24;P=0.02).STAI-Y2 scores were significantly higher in Ob without SG positive for BED(42.2±1.5 vs Ob negative for BED:39.6±1.0,P=0.04),while SHAPS scores and BDI II did not differ in the two groups(1.16±1.30 vs 0.89±1.02,P=0.49).A lower prevalence of BED(BES>17:11.4%vs 40.7%,P=0.001)and BDI-II(6.8±1.2 vs 13.8±1.9,P=0.005)was reported in Ob with SG than Ob without SG,on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG.Thirty-five percent of Ob with SG fulfilled the diagnosis of FD.SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups(18.2 vs 8.1%,P=0.2).Fifty-four percent of Ob with SG achieved surgical success excess weight loss>50%.Excess weight loss was negatively related to SHAPS total mean scores[adjusted B:-7.099(95%CI:-13.91 to-0.29),P=0.04].CONCLUSION Ob without SG showed a higher prevalence of PDS,mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior,whereas no differences were found in SHAPS score.Ob with SG showed a higher prevalence of PDS compared to Ob without SG.Concerning psychological aspect,BED and depression are less frequent in the Ob with SG,while both state and trait anxiety are significantly higher.Moreover,the more an Ob with SG is anhedonic,less surgical success was achieved.展开更多
Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of n...Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.展开更多
Objective: To analyze the acupoints selection rules in the treatment of functional dyspepsia using complex network technology. Method: This paper uses "functional dyspepsia" and "acupuncture" as se...Objective: To analyze the acupoints selection rules in the treatment of functional dyspepsia using complex network technology. Method: This paper uses "functional dyspepsia" and "acupuncture" as searching terms, searches the Chinese and English literature included in the five major databases of Pubmed, China National Knowledge Infrastructure, Sino Med, VIP and Wanfang databases until August 2021, and performs data mining and visualization of prescriptions so as to analyze the pattern of acupoints. Results: 128 papers involving 40 acupoints were selected. The top three acupoints in terms of frequency of acupuncture are Zusanli (ST 36), Neiguan (PC 6) and Zhongwan (RN 12);these three acupuncture points have the highest support for alliance. The core prescriptions for acupuncture in the treatment of functional dyspepsia can be divided into four following categories. The first category is ST 36, PC 6, Gongsun (SP 4), Neiting (ST 44), and Yinlingquan (SP 9);the second category is RN 12, Tianshu (ST 25), Guangyuan (RN 4), Qihai (RN 6), and Xiawan (RN 10);the third category is Zhangmen (IR 10), Liangmen (ST 21), Qimen (IR 14), Taichong (IR 3), and Sanyinjiao (SP 6);and the fourth category includes Weishu (BL 21), Pishu (BL 20), and Ganshu (BL18). Conclusion: The top three meridians with the highest frequency of acupuncture for functional dyspepsia are the Stomach Meridian of Foot-Yangming, the Conception Vessel and the Bladder Meridian of Foot-Taiyang. This paper analyses the prescription of acupuncture for functional dyspepsia through a complex network, which can more effectively summarize the pattern of acupuncture point selection from various aspects.展开更多
Functional dyspepsia (FD) is a common disease in the department of gastroenterology, and its incidence tends toincrease year by year. It has become one of the important diseases plaguing modern people. Western medicin...Functional dyspepsia (FD) is a common disease in the department of gastroenterology, and its incidence tends toincrease year by year. It has become one of the important diseases plaguing modern people. Western medicine isnot ideal in clinical treatment, and this disease is easy to relapse. Traditional Chinese medicine (TCM) treatmentFD has a unique potential advantage, mainly for the wide range of application, long-term application of smalladverse reactions, and obtaining certain curative effect in clinical application. This paper summarizes the progressof TCM in the treatment of FD in clinical practice, so as to provide a reference for the clinical application of TCMin the treatment of FD.展开更多
Functional dyspepsia(FD)is a regularly diagnosed clinical gastrointestinal ailment with a high incidence rate that can considerably impact patients’health and quality of life and impose a substantial financial burden...Functional dyspepsia(FD)is a regularly diagnosed clinical gastrointestinal ailment with a high incidence rate that can considerably impact patients’health and quality of life and impose a substantial financial burden.Modern research on the pathophysiology of functional dyspepsia has not thoroughly explained the underlying reasons.The condition does not manifest any significant organ abnormalities,which raises the disease’s difficulty coefficient.Major pathogenic exceptions in FD include gastrointestinal motor dysfunction,gastrointestinal hormone secretion problem,visceral hypersensitivity,and brain-gut axis.Several ion channels have reportedly been implicated in the pathophysiological process of FD.Therefore,it is crucial to comprehend the probable activities of various ion channels in FD.This study focuses on the current state of research on the possible role of several ion channels in the pathogenesis of FD.展开更多
AIM: To explore whether clinician-patient communication affects adherence to psychoactive drugs in functional dyspepsia(FD) patients with psychological symptoms. METHODS: A total of 262 FD patients with psychological ...AIM: To explore whether clinician-patient communication affects adherence to psychoactive drugs in functional dyspepsia(FD) patients with psychological symptoms. METHODS: A total of 262 FD patients with psychological symptoms were randomly assigned to four groups. The patients in Groups 1-3 were given flupentixol-melitracen(FM) plus omeprazole treatment. Those in Group 1 received explanations of both the psychological and gastrointestinal(GI) mechanisms of the generation of FD symptoms and the effects of FM. In Group 2, only the psychological mechanisms were emphasized. The patients in Group 3 were not given an explanation for the prescription of FM. Those in Group 4 were given omeprazole alone. The primary endpoints of this study were compliance rate and compliance index to FM in Groups 1-3. Survival analyses were also conducted. The secondary end points were dyspepsia and psychological symptom improvement in Groups 1-4. The correlations between the compliance indices and the reductions in dyspepsia and psychological symptom scores were also evaluated in Groups 1-3.RESULTS: After 8 wk of treatment, the compliance rates were 67.7% in Group 1, 42.4% in Group 2 and 47.7% in Group 3(Group 1 vs Group 2, P = 0.006; Group 1 vs Group 3, P = 0.033). The compliance index(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.024) with the FM regimen was significantly higher in Group 1 than in Groups 2 and 3. The survival analysis revealed that the patients in Group 1 exhibited a significantlyhigher compliance rate than Groups 2 and 3(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.018). The improvement in dyspepsia(Group 1 vs Group 2, P < 0.05; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01) and psychological symptom scores(anxiety: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01; depression: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.01; Group 1 vs Group 4, P < 0.01) in Group 1 were greater than those in Groups 2-4. The compliance indices were positively correlated with the reduction in symptom scores in Groups 1-3. CONCLUSION: Appropriate clinician-patient communication regarding the reasons for prescribing psychoactive drugs that emphasizes both the psychological and GI mechanisms might improve adherence to FM in patients with FD.展开更多
AIM: To evaluate whether Helicobacter pylori(H. pylori) eradication therapy benefits patients with functional dyspepsia(FD).METHODS: Randomized controlled trials(RCTs) investigating the efficacy and safety of H. pylor...AIM: To evaluate whether Helicobacter pylori(H. pylori) eradication therapy benefits patients with functional dyspepsia(FD).METHODS: Randomized controlled trials(RCTs) investigating the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English(up to May 2015) were identified by searching Pub Med, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio(RR) or a standard mean difference(SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0.RESULTS: This systematic review included 25 RCTs with a total of 5555 patients with FD. Twenty-three of these studies were used to evaluate the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.23(95%CI: 1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at ≥ 1 year(RR = 1.24; 95%CI: 1.12-1.37, P < 0.0001) but not during short-term follow-up at < 1 year(RR = 1.26; 95%CI: 0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of-0.01(95%CI:-0.11 to 0.08, P = 0.80). Six studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy(RR = 0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy(RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy(RR = 7.13; 95%CI: 3.68-13.81, P < 0.00001).CONCLUSION: The decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment.展开更多
AIM:To explore the incidence and psychological and behavioral characteristics of refractory functional dyspepsia(RFD)in China.METHODS:The subjects of this study were 1341 new outpatients with functional dyspepsia(FD)w...AIM:To explore the incidence and psychological and behavioral characteristics of refractory functional dyspepsia(RFD)in China.METHODS:The subjects of this study were 1341 new outpatients with functional dyspepsia(FD)who were diagnosed according to the RomeⅢcriteria at four hospitals in Guangdong Province between June and September 2012,and 100 healthy volunteers.All subjects completed questionnaires and scales administered.RESULTS:Three-hundred and twenty-seven of the 1341patients with FD had RFD(24.4%).Patients with RFD had a longer disease duration and a more severe form of the disease than patients with non-refractory FD(NRFD).The prevalence of depression and anxiety symptoms was higher in patients with RFD than in patients with NRFD.The prevalence of unhealthy eating behaviors,lack of physical activity,and sleeping disorders was higher in patients with RFD than in patients with NRFD.Patients with RFD sought medical advice on more occasions and spent more money on treatment than patients with NRFD.Finally,patients with RFD had poorer quality of life than patients with NRFD.CONCLUSION:RFD is not rare in clinical practice and should get attention by patients and doctors because of its long duration,severe symptoms,and associations with abnormal psychology and poor quality of life.展开更多
文摘Objective:To investigate the therapeutic effect of Biling Weitong Granules combined with oryz-aspergillus enzyme and pancreatin tablets on patients with reflux esophagitis with functional dyspepsia.Methods:Sixty patients diagnosed with reflux esophagitis with functional dyspepsia who were admitted to the Affiliated Hospital of Hebei University between June 2020 and June 2023 were selected and divided into two groups:the control group and the observation group,each consisting of 30 cases.The control group received oryz-aspergillus enzyme and pancreatin tablets only,while the observation group received Biling Weitong Granules in addition to the tablets.The clinical efficacy,Chinese medicine syndrome points,esophageal kinetic indexes,gastrointestinal hormone levels,and therapeutic safety of both groups were evaluated.Results:The total efficiency of the observation group reached 93.33%,significantly higher than the 73.33%of the control group(P<0.05).After treatment,patients in the observation group exhibited significantly lower scores for Chinese medicine symptoms such as early satiety,belching,abdominal distension,abdominal pain,and loss of appetite compared to the control group(P<0.05).Furthermore,the observation group showed significantly higher upper esophageal sphincter pressure,lower esophageal sphincter pressure,and distal esophageal contraction scores compared to the control group(P<0.05).Additionally,levels of gastric motility hormone,vasoactive intestinal peptide,and gastrin were significantly higher in the observation group compared to the control group(P<0.05).Throughout the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups,indicating comparable safety of the two treatment modalities(P>0.05).Conclusion:The combination of Biling Weitong Granules with oryz-aspergillus enzyme and pancreatin tablets demonstrates significant efficacy in the treatment of reflux esophagitis with functional dyspepsia,with a better safety profile.This finding warrants further clinical promotion.
文摘Objective:To explore the main acupoint prescription and mechanism of acupuncture in treating Functional dyspepsia(FD)by analyzing the clinical randomized controlled trial literature on acupoints and targets of acupuncture in the treatment of FD combined with association rule mining and bioinformatics/network pharmacology methods.Methods:Search relevant clinical randomized controlled trial literature on acupoints and therapeutic targets of acupuncture in the treatment of FD from eight databases from their inception to June 18th,2022.We obtained acupuncture selection points,meridian,and therapeutic targets and established acupoints database for acupuncture treatment of FD.FD-related targets were collected from GeneCards,DisGeNET,OMIM,and DrugBank databases.We obtained the potential targets of acupuncture on FD by taking the intersection of acupuncture for FD therapeutic targets and FD-related targets.We performed the protein-protein interaction network,Gene Ontology(GO)analysis,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Results:In this study,26 Randomized Controlled Trials related to acupuncture treatment of FD were retrieved.We obtained 29 acupoints,17 acupuncture for FD therapeutic targets,and 10 intersection targets.Tumor necrosis factor(TNF),Interleukin(IL)-1,and Neuropeptide Y(NPY)are key targets of acupuncture in the treatment of FD.Conclusion:ST36-CV12-PC6-LR3 is the main acupoint prescription for FD.Acupuncture may affect Neuroactive ligand-receptor interaction,Gastric acid secretion,and IL-17,TNF signaling pathways by regulating related key targets,and play a synergistic role in the treatment of FD by inhibiting gastric acid secretion,alleviating inflammatory response,regulating the brain-gut axis,improving mood and other aspects.
基金Supported by The Endoscope Center of the People’s Hospital of Henan Province Zhengzhou China
文摘AIM: To investigate whether there were symptom-based tendencies in the Helicobacter pylori (H. pylori) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conduct- ed. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching,epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 46%, 36%, 52.5% and 33.3%, respectively, and there was no significant difference from the placebo group (39.3%, 27.1%, 39.1% and 31.4%) (P > 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belch- ing were 41.4%, 33.3%, 50% and 31.4%, respective- ly, and did not differ from those in the placebo group (P > 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 34.8%, 27.9%, 41.1% and 26.7% respectively in the treatment group, with no significant difference from those in the placebo group (34.8%, 23.9%, 35.3% and 27.1%) (P > 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.
基金Supported by Project of the National Key Technology R&D Program during the 11th Five-Year Plan Period,No.2007BAI04B01Shanghai Leading Academic Discipline Project,No.Y0205
文摘AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were included in this study.One week after single-blinded placebo run-in treatment,baseline nocturnal intragastric pH,bile reflux and nocturnal dyspeptic symptoms of eligible patients,including epigastric pain or discomfort,abdominal distention and belching, were investigated with questionnaires.Patients exhibiting nocturnal dyspeptic symptoms were randomly and double-blindly assigned to domperidone group or placebo group.Nocturnal intragastric pH and percentage of duodenogastric bile reflux time were determined after treatment. RESULTS:Of the 85 FD patients,2 females withoutnocturnal symptoms,who responded to placebo run-in treatment,were excluded from the study,30(36.1%) exhibited nocturnal dyspeptic symptoms with increased duodenogastric bile reflux time(intragastric bilirubin absorbance>0.14)and mean gastric pH(confirming the existence of bile reflux)(P=0.021,0.023) at night were included in the study.Of these 30 patients,21(70%)had overt nocturnal duodenogastric bile reflux,which was significantly higher than that of those without nocturnal symptoms(P=0.026).The 30 patients were allocated to domperidone group or placebo group(n=15).The nocturnal duodenogastric bile reflux and gastric pH were significantly decreased after domperidone treatment(P=0.015,0.021).The severity score of nocturnal dyspeptic symptoms was also significantly decreased after domperidone treatment (P=0.010,0.015,0.026),which was positively correlated with the reduced nocturnal bile reflux or gastric pH(r=0.736,0.784,0.753 or r=0.679,0.715,0.697, P=0.039,0.036,0.037 or P=0.043,0.039,0.040). CONCLUSION:A subgroup of Chinese FD patients show overt nocturnal dyspeptic symptoms,which may be correlated with the excessive nocturnal duodenogastric bile reflux.Domperidone therapy can alleviate these symptoms.
文摘Hypervigilance and symptoms anticipation,visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia(FD)patients.Many patients recognize meals as the main triggering factor;thus,dietary manipulations often represent the first-line management strategy in this cohort of patients.Nonetheless,scarce quality evidence has been produced regarding the relationship between specific foods and/or macronutrients and the onset of FD symptoms,resulting in nonstandardized nutritional approaches.Most dietary advises are indeed empirical and often lead to exclusion diets,reinforcing in patients the perception of“being intolerant”to food and self-perpetuating some of the very mechanisms underlying dyspepsia physiopathology(i.e.,hypervigilance and symptom anticipation).Clinicians are often uncertain regarding the contribution of specific foods to dyspepsia physiopathology and dedicated professionals(i.e.,dietitians)are only available in tertiary referral settings.This in turn,can result in nutritionally unbalanced diets and could even encourage restrictive eating behaviors in severe dyspepsia.In this review,we aim at evaluating the relationship between dietary habits,macronutrients and specific foods in determining FD symptoms.We will provide an overview of the evidence-based nutritional approach that should be pursued in these patients,providing clinicians with a valuable tool in standardizing nutritional advises and discouraging patients from engaging into indiscriminate food exclusions.
基金Supported by the National Natural Science Foundation of China,No.81703923 and No.81820108033.
文摘BACKGROUND Functional dyspepsia(FD)is a common digestive disease with limited therapeutic options.According to evidence-based clinical practice,acupuncture or electroacupuncture(EA)seems to be a promising therapy for patients with FD.However,there is still a lack of systematic reviews that have analyzed current clinical trials for a better understanding of mechanisms involved in the ameliorating effect of acupuncture and EA on FD.AIM To evaluate the results and qualities of existing clinical evidence for researching the underlying mechanisms of acupuncture/EA in treating FD.METHODS A systematic search of the literature was performed to identify randomized controlled trials in which research on the mechanism of acupuncture or EA was conducted in FD patients.Databases searched included PubMed,EMBASE,Cochrane Library,and Web of Science.Data extraction and quality assessment were completed by two investigators independently and the results of quality evaluation were exported through Review Manager V5.3.RESULTS Eight studies were included in this review with a total of 17 items for detecting techniques for mechanistic research.Positive effects of acupuncture and EA were observed in regulating gastric motility,gastric accommodation,mental status,gastrointestinal hormones,and central and autonomic functions while improving dyspeptic symptoms and quality of life.CONCLUSION The key findings of this systematic review support the potential of acupuncture and EA in altering the heterogeneous pathophysiology in patients with FD.However,high-quality studies with well-planned designs are necessary to provide more credible evidence.
基金the National Natural Science Foundation of China(Grant No.81273746,and 81573806)Foundation on Beijing Key Laboratory of Functional Gastrointestinal Disorders Diagnosis and Treatment of Traditional Chinese Medicine(Grant No.BZ0374).
文摘Objective:To evaluate the efficacy and safety of Chinese herbal medicine(CHM)for the treatment of functional dyspepsia(FD).Methods:Web of Science,PubMed,EMBASE,Cochrane Library,and four other Chinese electronic databases,including China National Knowledge Infrastructure(CNKI),Chinese Biological Medical Database(CBM),Chinese Scientific Journals Database(VIP),and WanFang Database were used to search(up to Feb,2016)for randomized,double-blind,placebocontrolled trials recruiting adults with FD treated with CHM.Study selection,data extraction,quality assessment,and data analyses were conducted based on Cochrane standards using Review Manager software.Results:Fourteen publications(1424 patients)were included.Evidence revealed that CHM was more efficacious than the placebo in improving global dyspepsia symptoms(RR,1.45;95%CI,1.31e1.60),Chinese medicine syndrome(CMS)(RR,1.36;95%CI,1.23e1.50),and quality of life(SMD,0.30;95%CI,0.15e0.45)in FD patients.Furthermore,the difference in the incidence of adverse events between CHM and placebo groups had no statistical significance(RR,1.06;95%CI,0.66e1.70).Conclusion:This meta-analysis demonstrates that CHM has a therapeutic potential in treating FD with a certain safety.However,due to the restricted number of trials included,wellplanned,long-term studies are necessary to provide credible evidence.
基金We are grateful for the technical support provided by Dr.Lin Lv and Dr.FengyunWang(Xiyuan Hospital,affiliated with the Chinese Academy of TCM,Beijing,China)and Xin Ma(Beijing University of Chinese Medicine,Beijing,China).
文摘Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats with FD were isolated,cultured,and then divided into six groups as follows:control,model,domperidone,low-dose XSLJZD(LXSLJZD),medium-dose XSLJZD(MXSLJZD),and high-dose XSLJZD(HXSLJZD).Each group was administered the corresponding drug serum for intervention.Drug serum intervention conditions and proliferative activity of SMCs were tested by cholecystokinin octapeptide.Ghrelin,gastrin,somatostatin,and substance P(SP)levels were measured by ELISA.Somatostatin and SP mRNA expression was measured by real-time PCR.Results:A concentration of 10%drug serum for 24 h was decided to be the best intervention condition for later study.The mean optical density value in the model group was lower than that in the control group(P紏.001).Optical density values in the domperidone and HXSLJZD groups were higher than those in the model group(P?.025,P?.032,respectively).Gastrin,SP,and ghrelin levels in the model group were lower(P?.007,P?.037,P?.005,respectively),but somatostatin levels were higher,compared with those in the control group(P?.031).Gastrin,SP,and ghrelin levels in the domperidone,MXSLJZD,and HXSLJZD groups were higher than those in the model group(all P<.05).Somatostatin levels in the four drug-treated groups were lower than those in the model group(P?.002,P?.007,P?.001,P?.009,respectively).SP mRNA levels in the model group were lower than those in the control,domperidone,MXSLJZD,and HXSLJZD groups(P?.037 P?.016,P?.025,P?.002,respectively).Somatostatin mRNA levels in the model group were higher than those in the control and MXSLJZD groups(P紏.042,P紏.035).Conclusions:XSLJZD and domperidone drug serum effectively promote proliferative activity of gastric antrum SMCs in an FD model.The mechanism of this activity may be regulated by gastrointestinal hormones.
基金Capital project for application and promotion of clinical researches(No.Z171100001017123)Capital specialized scientific research proect of health development for young excellent talents(No.2018-4-4078)。
文摘Objective:Based on data mining software,applying frequent itemsets,association rules,hierarchical clustering,complex networks and other data mining methods to analyze the usage and compatibility of traditional Chinese medicine(TCM)patent compound for functional dyspepsia.Method:Use the Chinese patent database to search the compound for the treatment of functional dyspepsia,exclude traditional Chinese medicine extracts,single drugs,combined use of Chinese and Western medicines,etc.,screen the patented compound of TCM,establish an Excel data table,and apply data mining software to The data is subjected to frequency statistics,association rules,cluster analysis and complex network analysis.Result:A total of 238 prescriptions for functional dyspepsia were screened.The four qi of the drugs were mainly warm and calm,the five flavors were mainly sweet and spicy,and the spleen and stomach were the main meridians.The top 10 Chinese medicines with higher frequency are Shanzha、Chenpi、Gancao、Maiya、Jineijin、Fuling、Baizhu、Shenqu、Houpo、Banxia;frequent itemsets show that the drugs are mainly compatible with qi and spleen,qi and digestion;association rules The analysis shows that the common drug pairs used in the treatment of functional dyspepsia include Chenpi-Shanzha、Maiya-Shanzha、Jineijin-Shanzha,etc.;cluster analysis found that there are 4 types of drugs for functional dyspepsia,mainly including drugs for regulating qi-flowing for harmonizing stomach,drugs for soothing liver and promoting Qi,drugs for eliminating food and resolving accumulation,drugs for benefiting qi and strengthening spleen;the 22-flavor Chinese medicine in the core drug network,the core compatibility is mainly to eliminate stagnation and spleen.Conclusion:Data mining research provides a reference for the clinical treatment of functional dyspepsia and the development of TCM formulas;Clinical treatment of functional dyspepsia should grasp the basic principles of strengthening vital energy and eliminating pathogenic factors to benefit qi,strengthen the spleen,and eliminate food.It is a basic treatment method,taking into account the methods of regulating qi-flowing for harmonizing stomach,soothing the liver and relieving depression,relieving dampness and dampness,and combining the specific conditions of patients with syndrome differentiation and treatment.
文摘BACKGROUND: It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental factors can lead to excessive gastrointestinal consensual reaction, and result in different brain-gut axis disturbance, and then cause the gastrointestinal sensorimotor abnormality and endocrine changes.OBJECTIVE: To observe the effect of antidepressant treatment on the changes of water load and serum cortisol in patients with functional dyspepsia, and analyze the therapeutic mechanism.DESIGN: A comparative observation.SETTING: The First Affiliated Hospital o Zhengzhou University.PARTICIPANTS: Forty-five patients with functional dyspepsia accompanied by depression were selected from the Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University from July 2004 to July 2006, and they were 25 - 65 years of age, and their disease courses ranged 1 - 10 years. They were all accorded with the diagnostic standards for Rome Ⅱ functional dyspepsia functional dyspepsia. As the patients' will, they were divided into treatment group (n =30, 12 males and 18 females) and control group (n =15, 6 males and 9 females), and there were no significant differences in the data between the two groups (P 〉 0.05). The programs were discussed and agreed by the committee of medical ethics of the First Affiliated Hospital of Zhengzhou University. Informed contents were obtained from all the patients.METHODS: In the treatment group, the patients were treated with venlafaxine sustained release capsule (75 mg per day), and those with sleep disorder were added by benzodiazepines (alprazolam). In the control group, the patients were given routine treatments of antacid, prokinetics, etc. Before and after 8-week treatment, the following examinations were performed: ① The gastrointestinal symptoms were assessed according to the symptoms; ② The severity of depression was evaluated with Hamilton depression scale (HAMD); ③The relaxation of proximal stomach was observed using water load test; ④ The serum level of cortisol was detected.MAIN OUTCOME MEASURES: ① Symptom score; ② HAMD score; ③ Water load amount; ④Serum level of cortisol.RESULTS: All the 45 patients were involved in the analysis of results. ① Symptom score: The scores of gastrointestinal symptoms were decreased as compared with those before treatment in both the treatment group and control group (P 〈 0.05). ② HAMD scores: The scores of HAMD were decreased as compared with those before treatment in both the treatment group and control group (P 〈 0.05). ③ Water load amount:The total effective rate was significantly higher in the treatment group than the control group (P 〈 0.05). ④The serum levels of cortisol after treatment were significantly lower than those before treatment in the patients with severe gastrointestinal symptoms in the treatment group and control group (P 〈 0.05).CONCLUSION: Antidepressants can normalize the cortisol level of patients with functional dyspepsia, and then decrease gastric sensitivity and ameliorates the receptive relaxation of proximal stomach, also increase the water load amount correspondingly, and finally control the gastrointestinal symptoms of functional dyspepsia.
文摘BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has been described in Ob after sleeve gastrectomy(SG).Hedonic response to a meal is dissociable from satiation in healthy subjects.Anhedonia is the lowered ability to experience pleasure.There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.AIM To assess the relationship among anhedonia,BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.METHODS Eighty-one Ob without SG,45 Ob with SG and 55 healthy controls(HC)were studied.All subjects fulfilled the binge eating scale(BES)to investigate BED,the validated 14 items Snaith-Hamilton pleasure scale(SHAPS)to assess Anhedonia as well as the Beck Depression Inventory-II(BDI II)and State Trait Anxiety Inventory(STAI)questionnaires to screen for depression and anxiety.All patients underwent a standardized questionnaire investigating the intensity-frequency scores(0-6)of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia(FD)and its subtypes according to ROME IV criteria.RESULTS Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED(OR:4.7;95.0%CI 1.23-18.24;P=0.02).STAI-Y2 scores were significantly higher in Ob without SG positive for BED(42.2±1.5 vs Ob negative for BED:39.6±1.0,P=0.04),while SHAPS scores and BDI II did not differ in the two groups(1.16±1.30 vs 0.89±1.02,P=0.49).A lower prevalence of BED(BES>17:11.4%vs 40.7%,P=0.001)and BDI-II(6.8±1.2 vs 13.8±1.9,P=0.005)was reported in Ob with SG than Ob without SG,on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG.Thirty-five percent of Ob with SG fulfilled the diagnosis of FD.SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups(18.2 vs 8.1%,P=0.2).Fifty-four percent of Ob with SG achieved surgical success excess weight loss>50%.Excess weight loss was negatively related to SHAPS total mean scores[adjusted B:-7.099(95%CI:-13.91 to-0.29),P=0.04].CONCLUSION Ob without SG showed a higher prevalence of PDS,mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior,whereas no differences were found in SHAPS score.Ob with SG showed a higher prevalence of PDS compared to Ob without SG.Concerning psychological aspect,BED and depression are less frequent in the Ob with SG,while both state and trait anxiety are significantly higher.Moreover,the more an Ob with SG is anhedonic,less surgical success was achieved.
基金2014 special research project of Chinese medicine industry of State Administration of Traditional Chinese Medicine(No.201407001-12)Key R&D Program Project of Shanxi Province(No.201703D321020)
文摘Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.
基金The study was supported by the Tianjin municipal health and Health Committee and Tianjin Administration of traditional Chinese Medicine(Scientific research project of integrated traditional Chinese and Western Medicine NO.2019027).
文摘Objective: To analyze the acupoints selection rules in the treatment of functional dyspepsia using complex network technology. Method: This paper uses "functional dyspepsia" and "acupuncture" as searching terms, searches the Chinese and English literature included in the five major databases of Pubmed, China National Knowledge Infrastructure, Sino Med, VIP and Wanfang databases until August 2021, and performs data mining and visualization of prescriptions so as to analyze the pattern of acupoints. Results: 128 papers involving 40 acupoints were selected. The top three acupoints in terms of frequency of acupuncture are Zusanli (ST 36), Neiguan (PC 6) and Zhongwan (RN 12);these three acupuncture points have the highest support for alliance. The core prescriptions for acupuncture in the treatment of functional dyspepsia can be divided into four following categories. The first category is ST 36, PC 6, Gongsun (SP 4), Neiting (ST 44), and Yinlingquan (SP 9);the second category is RN 12, Tianshu (ST 25), Guangyuan (RN 4), Qihai (RN 6), and Xiawan (RN 10);the third category is Zhangmen (IR 10), Liangmen (ST 21), Qimen (IR 14), Taichong (IR 3), and Sanyinjiao (SP 6);and the fourth category includes Weishu (BL 21), Pishu (BL 20), and Ganshu (BL18). Conclusion: The top three meridians with the highest frequency of acupuncture for functional dyspepsia are the Stomach Meridian of Foot-Yangming, the Conception Vessel and the Bladder Meridian of Foot-Taiyang. This paper analyses the prescription of acupuncture for functional dyspepsia through a complex network, which can more effectively summarize the pattern of acupuncture point selection from various aspects.
文摘Functional dyspepsia (FD) is a common disease in the department of gastroenterology, and its incidence tends toincrease year by year. It has become one of the important diseases plaguing modern people. Western medicine isnot ideal in clinical treatment, and this disease is easy to relapse. Traditional Chinese medicine (TCM) treatmentFD has a unique potential advantage, mainly for the wide range of application, long-term application of smalladverse reactions, and obtaining certain curative effect in clinical application. This paper summarizes the progressof TCM in the treatment of FD in clinical practice, so as to provide a reference for the clinical application of TCMin the treatment of FD.
基金“Double first-class”construction project of Mongolian medicine scientific research and innovation team fund(190301)International cooperative scientific and technological innovation project of Mongolian medicine standardization research(MDK2018009)+1 种基金2018 National Civil Affairs Commission-Ministry of Education Mongolian Medicine R&D Engineering Key Laboratory Open Project(MDK2018056)Mongolian Medicine R&D National and Local Joint Engineering Research Center Open Fund Project(MDK2019044).
文摘Functional dyspepsia(FD)is a regularly diagnosed clinical gastrointestinal ailment with a high incidence rate that can considerably impact patients’health and quality of life and impose a substantial financial burden.Modern research on the pathophysiology of functional dyspepsia has not thoroughly explained the underlying reasons.The condition does not manifest any significant organ abnormalities,which raises the disease’s difficulty coefficient.Major pathogenic exceptions in FD include gastrointestinal motor dysfunction,gastrointestinal hormone secretion problem,visceral hypersensitivity,and brain-gut axis.Several ion channels have reportedly been implicated in the pathophysiological process of FD.Therefore,it is crucial to comprehend the probable activities of various ion channels in FD.This study focuses on the current state of research on the possible role of several ion channels in the pathogenesis of FD.
基金Supported by National Natural Science Foundation of China,No.81470812,No.81270463,No.31171106,and No.81070302(to Chen SL)
文摘AIM: To explore whether clinician-patient communication affects adherence to psychoactive drugs in functional dyspepsia(FD) patients with psychological symptoms. METHODS: A total of 262 FD patients with psychological symptoms were randomly assigned to four groups. The patients in Groups 1-3 were given flupentixol-melitracen(FM) plus omeprazole treatment. Those in Group 1 received explanations of both the psychological and gastrointestinal(GI) mechanisms of the generation of FD symptoms and the effects of FM. In Group 2, only the psychological mechanisms were emphasized. The patients in Group 3 were not given an explanation for the prescription of FM. Those in Group 4 were given omeprazole alone. The primary endpoints of this study were compliance rate and compliance index to FM in Groups 1-3. Survival analyses were also conducted. The secondary end points were dyspepsia and psychological symptom improvement in Groups 1-4. The correlations between the compliance indices and the reductions in dyspepsia and psychological symptom scores were also evaluated in Groups 1-3.RESULTS: After 8 wk of treatment, the compliance rates were 67.7% in Group 1, 42.4% in Group 2 and 47.7% in Group 3(Group 1 vs Group 2, P = 0.006; Group 1 vs Group 3, P = 0.033). The compliance index(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.024) with the FM regimen was significantly higher in Group 1 than in Groups 2 and 3. The survival analysis revealed that the patients in Group 1 exhibited a significantlyhigher compliance rate than Groups 2 and 3(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.018). The improvement in dyspepsia(Group 1 vs Group 2, P < 0.05; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01) and psychological symptom scores(anxiety: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01; depression: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.01; Group 1 vs Group 4, P < 0.01) in Group 1 were greater than those in Groups 2-4. The compliance indices were positively correlated with the reduction in symptom scores in Groups 1-3. CONCLUSION: Appropriate clinician-patient communication regarding the reasons for prescribing psychoactive drugs that emphasizes both the psychological and GI mechanisms might improve adherence to FM in patients with FD.
文摘AIM: To evaluate whether Helicobacter pylori(H. pylori) eradication therapy benefits patients with functional dyspepsia(FD).METHODS: Randomized controlled trials(RCTs) investigating the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English(up to May 2015) were identified by searching Pub Med, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio(RR) or a standard mean difference(SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0.RESULTS: This systematic review included 25 RCTs with a total of 5555 patients with FD. Twenty-three of these studies were used to evaluate the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.23(95%CI: 1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at ≥ 1 year(RR = 1.24; 95%CI: 1.12-1.37, P < 0.0001) but not during short-term follow-up at < 1 year(RR = 1.26; 95%CI: 0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of-0.01(95%CI:-0.11 to 0.08, P = 0.80). Six studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy(RR = 0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy(RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy(RR = 7.13; 95%CI: 3.68-13.81, P < 0.00001).CONCLUSION: The decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment.
文摘AIM:To explore the incidence and psychological and behavioral characteristics of refractory functional dyspepsia(RFD)in China.METHODS:The subjects of this study were 1341 new outpatients with functional dyspepsia(FD)who were diagnosed according to the RomeⅢcriteria at four hospitals in Guangdong Province between June and September 2012,and 100 healthy volunteers.All subjects completed questionnaires and scales administered.RESULTS:Three-hundred and twenty-seven of the 1341patients with FD had RFD(24.4%).Patients with RFD had a longer disease duration and a more severe form of the disease than patients with non-refractory FD(NRFD).The prevalence of depression and anxiety symptoms was higher in patients with RFD than in patients with NRFD.The prevalence of unhealthy eating behaviors,lack of physical activity,and sleeping disorders was higher in patients with RFD than in patients with NRFD.Patients with RFD sought medical advice on more occasions and spent more money on treatment than patients with NRFD.Finally,patients with RFD had poorer quality of life than patients with NRFD.CONCLUSION:RFD is not rare in clinical practice and should get attention by patients and doctors because of its long duration,severe symptoms,and associations with abnormal psychology and poor quality of life.