Camilleri M, Malagelada J R, Kao P C, Zinsmeister A R
Dig Dis Sci. 1986 Nov;31(11):1169-77. doi: 10.1007/BF01296514.
It has been suggested that functional dyspepsia might arise from the effect of stress on upper gut motility in susceptible individuals. The aim of this study was to evaluate posticibal antral motility in the presence and absence of sustained experimental stress by means of a transcutaneous electrical nerve stimulator. Two groups of patients could be recognized from these studies: first, those with postcibal antral hypomotility that was not changed during stress; and second, patients with normal postcibal motility which was normally suppressed by stress. Experimental stress significantly increased skin conductance and plasma beta-endorphin levels. However, in these two groups, there were no differences in clinical presentation and personality traits or in autonomic and humoral variables either before or during stress. Stepwise discriminant analysis of the autonomic or humoral responses to stress was unable to predict the different postcibal antral motor responses among the subsets of patients with functional dyspepsia. These data suggest that there are two subtypes of antral motility in functional dyspepsia: disordered gastric function under basal conditions resulting in antral hypomotility, and normal basal antral motility and autonomic and gastric motor responses to stress. In the latter subgroup, the cause of symptoms is unclear, but it appears not to be a motility disorder.
有人认为，功能性消化不良可能源于压力对易感个体上消化道运动的影响。本研究的目的是通过经皮电神经刺激器评估在存在和不存在持续性实验性压力的情况下餐后胃窦的运动情况。从这些研究中可识别出两组患者：第一组，餐后胃窦运动减弱且在压力期间未发生变化的患者；第二组，餐后运动正常但通常会被压力抑制的患者。实验性压力显著增加了皮肤电导和血浆β-内啡肽水平。然而，在这两组患者中，压力前后的临床表现、人格特质以及自主神经和体液变量均无差异。对压力的自主神经或体液反应进行逐步判别分析，无法预测功能性消化不良患者亚组之间不同的餐后胃窦运动反应。这些数据表明，功能性消化不良存在两种胃窦运动亚型：基础条件下胃功能紊乱导致胃窦运动减弱，以及基础胃窦运动正常且对压力的自主神经和胃运动反应正常。在后一亚组中，症状的原因尚不清楚，但似乎不是运动障碍。
