University of Miami, Division of Gastroenterology, 1120 NW 14th Street, Miami, FL 33136, USA.
Expert Opin Pharmacother. 2013 Sep;14(13):1737-53. doi: 10.1517/14656566.2013.809063. Epub 2013 Jun 19.
Functional dyspepsia (FD) is a highly prevalent and challenging disorder which impacts patients' quality of life and poses a considerable socioeconomic burden. Given the vagueness of the definition of FD based on the current Rome III criteria's expert opinion, the diagnosis of FD continues to be one of exclusion. Despite efforts to better define what constitutes FD, validity of such diagnostic criteria remains controversial given the lack of a distinct pathophysiologic mechanism.
New insights into the pathophysiology of FD have expanded our treatment options for the syndrome. This review will discuss the current pharmacologic treatments of FD with particular focus on the more robust randomized controlled trials to date.
Recently, the understanding of the pathophysiology of FD has evolved with novel hypothesis such as sensorimotor abnormalities of the stomach or duodenum, genetic polypmorphisms, psychological comorbidities, food sensitivities and allergies, and immune dysregulation found to be possibly responsible for its pathogenesis. Despite the expanding knowledge about the likely multifactorial pathophysiology of FD, its treatment remains a challenge.
功能性消化不良（FD）是一种高发且具有挑战性的疾病，会影响患者的生活质量，并造成相当大的社会经济负担。鉴于当前基于罗马 III 标准的专家意见定义的 FD 具有模糊性，FD 的诊断仍然是一种排除性诊断。尽管人们努力更好地定义 FD 的构成，但由于缺乏明确的病理生理机制，这些诊断标准的有效性仍然存在争议。
FD 的病理生理学的新见解扩大了我们对该综合征的治疗选择。这篇综述将讨论 FD 的当前药物治疗方法，特别关注迄今为止更有力的随机对照试验。
最近，FD 的病理生理学的理解已经发展，出现了一些新的假说，例如胃或十二指肠的感觉运动异常、遗传多态性、心理合并症、食物敏感性和过敏以及免疫失调，这些可能与疾病的发病机制有关。尽管对 FD 的可能多因素病理生理学的了解不断扩大，但对其治疗仍然是一个挑战。
