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[根除与促动力联合治疗对功能性消化不良餐后不适综合征患者临床表现、心理状态及生活质量的影响:随机前瞻性研究]

[INFLUENCE OF COMBINED ERADICATION AND PROKINETIC THERAPY ON CLINICAL MANIFESTATIONS, PSYCHOLOGICAL STATUS AND QUALITY OF LIFE OF PATIENTS WITH FUNCTIONAL DYSPEPSIA - POSTPRANDIAL DISTRESS SYNDROME: RANDOMIZED PROSPECTIVE STUDY].

作者信息

Solovyova G, Kvacheniuk K, Alianova T, Svintsitskyi I

机构信息

1Bogomolets National Medical University, Kyiv; 2Gastro center of the Clinic "Oberig", Kyiv; Ukraine.

1Bogomolets National Medical University, Kyiv; 3CNE "Kyiv City Consultative and Diagnostic Center" of the executive body of the Kyiv City Council, Kyiv, Ukraine.

出版信息

Georgian Med News. 2021 Mar(312):61-67.

Abstract

Functional dyspepsia - postprandial distress-syndrome (FD-PDS) is one of the most common reasons for seeking medical attention of general practitioners, internists and gastroenterologists worldwide. Standard approaches to the treatment of patients with postprandial distress syndrome are only effective in small amount of cases. Aim of the study - comparative assessment of the effectiveness of combined eradication and prokinetic therapy and eradication therapy only in the treatment of FD-PDS by studying their effect on the clinical manifestations of the disease, patients' psychological status and quality of life. This was a randomized prospective study among patients with FD-PDS in the presence of Helicobater pylori invasion. Participants from group 1 - 65 patients - received eradication therapy and prokinetic itoprid hydrochloride 50 mg three times a day; participants in group 2 - 61 patients - received only eradication therapy for 14 days. Helicobacter pylori was evaluated using a rapid one-step immunochromatographic test to detect stool antigen, or using PCR for Helicobacter pylori DNA, or using a histological method. To assess the severity of dyspeptic and concomitant gastroenterological symptoms, a 7-point Likert scale was used; to assess the severity of anxiety and depression in dynamics - Hospital Anxiety and Depression Scale (HADS); to assess the quality of life indicators - the SF-36 questionnaire. The duration of the study was 30 days. Combined eradication and prokinetic therapy, in comparison with eradication therapy only, is more effective in the treatment of FD-PDS. The additional use of itopride hydrochloride contributes to a more effective decrease in the severity and a longer elimination of symptoms of the disease (p˂0.05), helps to reduce the level of depression (p=0.002) and improve the quality of life indicators on the scales of physical functioning (p=0.032), role-physical functioning (p=0.039), bodily pain (p=0.0001), general health (p = 0.041), vitality (p=0.0001), social functioning (p=0.048).

摘要

功能性消化不良-餐后不适综合征(FD-PDS)是全球全科医生、内科医生和胃肠病学家接诊患者的最常见原因之一。餐后不适综合征患者的标准治疗方法仅在少数病例中有效。本研究的目的——通过研究联合根除和促动力治疗与仅根除治疗对疾病临床表现、患者心理状态和生活质量的影响,对两者在FD-PDS治疗中的有效性进行比较评估。这是一项针对存在幽门螺杆菌感染的FD-PDS患者的随机前瞻性研究。第一组的65名参与者接受根除治疗及盐酸伊托必利促动力治疗,每日3次,每次50毫克;第二组的61名参与者仅接受为期14天的根除治疗。采用快速一步免疫层析法检测粪便抗原、聚合酶链反应检测幽门螺杆菌DNA或组织学方法对幽门螺杆菌进行评估。采用7分量表评估消化不良及伴随的胃肠症状的严重程度;采用医院焦虑抑郁量表(HADS)动态评估焦虑和抑郁的严重程度;采用SF-36问卷评估生活质量指标。研究持续时间为30天。与仅根除治疗相比,联合根除和促动力治疗在FD-PDS治疗中更有效。额外使用盐酸伊托必利有助于更有效地减轻疾病严重程度并更长期地消除症状(p<0.05),有助于降低抑郁水平(p=0.002),并改善身体功能(p=0.032)、角色身体功能(p=0.039)、身体疼痛(p=0.0001)、总体健康(p = 0.041)、活力(p=0.0001)、社会功能(p=0.048)等方面的生活质量指标。

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