Zala Alkesh V, Walker Marjorie M, Talley Nicholas J
John Hunter Hospital, Department of Gastroenterology, New Lambton Heights , Newcastle, NSW , Australia
Expert Opin Emerg Drugs. 2015 Jun;20(2):221-33. doi: 10.1517/14728214.2015.1009827. Epub 2015 Feb 3.
Functional dyspepsia (FD) is a relatively common gastrointestinal clinical condition that remains poorly understood. Controversies remain regarding the definition, pathophysiology and optimum treatment. The current treatment of FD is limited and no established regimen is available.
Recent advances have improved our understanding of the pathophysiology of the disease and have led to the development of newer tailored therapies. Novel agents such as the motilin receptor agonist camicinal and the muscarinic M1 and M2 receptor antagonist acotiamide appear promising; however, the need for a safe and efficacious treatment remains largely unmet. This review describes the currently available management options for FD and critically evaluates emerging therapies.
The optimal treatment for FD is yet to be determined. A proton pump inhibitor or a prokinetic agent constitutes primary treatment. Helicobacter pylori testing and eradication is recommended. Based on currently available data, acotiamide appears promising, particularly in postprandial distress syndrome. Further large-scale multicentered trials are required to define the duration of treatment and the side-effect profile.
功能性消化不良（FD）是一种相对常见的胃肠道临床病症，但人们对其了解仍然有限。在定义、病理生理学和最佳治疗方法方面仍存在争议。目前FD的治疗方法有限，尚无既定的治疗方案。
最近的进展增进了我们对该疾病病理生理学的理解，并促使开发出更新的针对性疗法。新型药物如胃动素受体激动剂卡米地那和毒蕈碱M1及M2受体拮抗剂阿考替胺似乎前景良好；然而，对安全有效治疗方法的需求在很大程度上仍未得到满足。本综述描述了目前FD可用的管理选项，并对新兴疗法进行了批判性评估。
FD的最佳治疗方法尚未确定。质子泵抑制剂或促动力剂构成主要治疗方法。建议进行幽门螺杆菌检测和根除。根据现有数据，阿考替胺似乎前景良好，尤其是在餐后不适综合征方面。需要进一步开展大规模多中心试验来确定治疗持续时间和副作用情况。
