Kahn K L, Greenfield S
J Clin Gastroenterol. 1986 Jun;8(3 Pt 2):346-58. doi: 10.1097/00004836-198606002-00005.
Diagnostic approaches to the patient with dyspepsia include immediate evaluation with an upper gastrointestinal series, immediate study with esophagogastroduodenoscopy (EGD), or empiric medical treatment, reserving diagnostic evaluation for patients with complications and persistent symptoms after therapy. A literature review of dyspepsia as a symptom, and of duodenal ulcer, gastric ulcer, gastroduodenitis, and gastric cancer summarizes how the diagnostic approaches to the dyspeptic patient affect the precision of diagnostic information, efficacy, patient outcome, and cost. For patients without clinically obvious disease, an approach is developed which reduces cost and retains optimal patient management. The strategy proposes the use of empiric medical therapy while reserving EGD for those few dyspeptic patients who have no or minimal response to therapy after 7 to 10 days, and for the approximately 30% of patients whose symptoms persist, improved, but not resolved after a 6 to 8 week period.
消化不良患者的诊断方法包括采用上消化道造影进行即刻评估、通过食管胃十二指肠镜检查（EGD）进行即刻检查，或进行经验性药物治疗，仅对治疗后出现并发症和持续症状的患者进行诊断性评估。一篇关于消化不良这一症状以及十二指肠溃疡、胃溃疡、胃十二指肠炎症和胃癌的文献综述总结了针对消化不良患者的诊断方法如何影响诊断信息的准确性、疗效、患者预后和成本。对于无明显临床疾病的患者，制定了一种既能降低成本又能保持最佳患者管理的方法。该策略建议采用经验性药物治疗，而对于那些在7至10天后对治疗无反应或反应极小的少数消化不良患者，以及约30%症状持续、改善但在6至8周后仍未解决的患者，保留EGD检查。
