功能性烧心：刺激因素、疼痛与大脑。
Functional heartburn: the stimulus, the pain, and the brain.
作者信息
Fass R, Tougas G
机构信息
Department of Medicine, Section of Gastroenterology, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson 85723, USA.
出版信息
Gut. 2002 Dec;51(6):885-92. doi: 10.1136/gut.51.6.885.
Abstract
Functional heartburn is a common disorder and appears to be composed of several distinct subgroups. Identifying the different subgroups based on clinical history only is not achievable at present. The mechanisms responsible for pain, clinical characteristics, and the optimal therapeutic approach remain poorly understood. Response to potent antireflux treatment is relatively limited. Current and future treatment strategies for functional heartburn patients who have failed standard dose proton pump inhibitors (PPIs) include increased PPI dose in some, as well as addition of pain modulators in others.
摘要
功能性烧心是一种常见病症，似乎由几个不同的亚组构成。目前仅根据临床病史来识别不同亚组是无法实现的。疼痛的机制、临床特征以及最佳治疗方法仍知之甚少。对强效抗反流治疗的反应相对有限。对于标准剂量质子泵抑制剂（PPI）治疗失败的功能性烧心患者，当前及未来的治疗策略包括对部分患者增加PPI剂量，以及对其他患者添加疼痛调节剂。
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本文引用的文献
1
Cardiac autonomic function and oesophageal acid sensitivity in patients with non-cardiac chest pain.
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2
Duodenal fat intensifies the perception of heartburn.
Gut. 2001 Nov;49(5):624-8. doi: 10.1136/gut.49.5.624.
3
Sustained esophageal contraction: a motor correlate of heartburn symptom.
Am J Physiol Gastrointest Liver Physiol. 2001 Sep;281(3):G743-51. doi: 10.1152/ajpgi.2001.281.3.G743.
4
Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: effect of omeprazole.
Gastroenterology. 2001 Jun;120(7):1599-606. doi: 10.1053/gast.2001.24840.
5
Acid, nonacid, and gas reflux in patients with gastroesophageal reflux disease during ambulatory 24-hour pH-impedance recordings.
Gastroenterology. 2001 Jun;120(7):1588-98. doi: 10.1053/gast.2001.24841.
6
"Unexplained" somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift?
Ann Intern Med. 2001 May 1;134(9 Pt 2):926-30. doi: 10.7326/0003-4819-134-9_part_2-200105011-00018.
7
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Ann Intern Med. 2001 May 1;134(9 Pt 2):803-8. doi: 10.7326/0003-4819-134-9_part_2-200105011-00002.
8
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9
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