Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
J Gastroenterol Hepatol. 2012 Apr;27(4):626-41. doi: 10.1111/j.1440-1746.2011.07037.x.
BACKGROUND AND AIM: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared with the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. METHODS: Consensus team members were selected from Asian experts and consensus development was carried out by using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using a keypad voting system. A grade of evidence and strength of recommendation were applied to each statement according to the method of the GRADE Working Group. RESULTS: Twenty-nine consensus statements were finalized, including seven for definition and diagnosis, five for epidemiology, nine for pathophysiology, and eight for management. Algorithms for diagnosis and management of functional dyspepsia were added. CONCLUSIONS: This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.
背景与目的:与西方相比,亚洲国家的食物、生活方式和幽门螺杆菌感染流行等环境因素存在广泛差异,亚洲人的生理功能和遗传因素也可能与西方人不同。为了引起人们对来自亚洲国家的这些数据的关注,阐明亚洲专家的经验和观点,并为亚洲初级保健医生提供功能性消化不良管理的相关指南,建立亚洲功能性消化不良共识至关重要。
方法:共识小组成员选自亚洲专家,采用改良 Delphi 法进行共识制定。共识小组收集了关于功能性消化不良的已发表论文,特别是来自亚洲的论文,并根据提出的临床问题制定候选共识陈述。在第一次面对面会议上,对每一条陈述进行了审查,并进行了两次电子邮件投票。在第二次面对面会议上,使用按键投票系统对每条陈述进行最终投票。根据 GRADE 工作组的方法,对每一条陈述应用了证据等级和推荐强度。
结果:最终确定了 29 条共识陈述,包括 7 条用于定义和诊断,5 条用于流行病学,9 条用于病理生理学,8 条用于管理。还添加了功能性消化不良的诊断和管理算法。
结论:由亚洲专家制定的这一共识体现了亚洲功能性消化不良的独特特征,将为亚洲初级保健医生提供功能性消化不良的诊断和管理指南。
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