Huang Qian, Zheng Shaopeng, Cai Ting, Zhang Suxin, Su Qian, Wang Fen
Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
Hunan Key Laboratory of Non Resolving Inflammation and Cancer, Changsha, China.
Front Med (Lausanne). 2022 Jul 22;9:859661. doi: 10.3389/fmed.2022.859661. eCollection 2022.
Patients with functional dyspepsia (FD) are often accompanied by mood disorders (MDs). This study aimed to identify factors associated with MDs in patients with FD and evaluate the efficacy of targeted treatment plans.
Relevant scales were used to assess MDs. Patients with FD having MDs and acid reflux were treated with flupentixol and melitracen (FM) and acid-suppressive therapy (AST) (histamine-2 receptor antagonists (H2RAs) (group A) or proton pump inhibitors (PPIs) (group B)), and those without acid reflux (group C) did not receive AST. Patients with FD without MDs were randomly administered H2RAs (group D) or PPIs (group E). The primary endpoints were factors associated with MDs and improvement in gastrointestinal (GI) symptoms and MDs in patients with FD.
A total of 362 patients with FD were enrolled in this study. Patients with FD having high GI score and low education were found prone to MDs. At week 2, the remission rate of overall GI symptoms and depression was significantly higher in group B than that in groups A and C [GI: 72.72% (32/44) vs. 47.73% (21/44) and 72.72% (32/44) vs. 38.94% (44/113), all < 0.05; depression: 72.22% (26/36) vs. 41.67% (15/36) and 72.22% (26/36) vs. 41.57% (37/89), all < 0.05]. Furthermore, the remission rate of overall GI symptoms was significantly higher in group E than that in group D [60.29% (41/68) vs. 42.65% (29/68), < 0.05]. At week 8, similar efficacies and adverse reactions were observed in these groups.
The risk factors for MDs were high GI scores and low literacy rates. Thus, targeted treatment (FM+PPIs for patients with MDs; PPIs for patients without MDs) can improve the efficacy of patients with FD.
www.chictr.org.cn, identifier ChiCTR2100053126.
功能性消化不良（FD）患者常伴有情绪障碍（MDs）。本研究旨在确定FD患者中与MDs相关的因素，并评估针对性治疗方案的疗效。
使用相关量表评估MDs。伴有MDs和胃酸反流的FD患者接受氟哌噻吨美利曲辛（FM）和抑酸治疗（AST）（组胺-2受体拮抗剂（H2RAs）（A组）或质子泵抑制剂（PPIs）（B组）），而无胃酸反流的患者（C组）不接受AST。无MDs的FD患者随机给予H2RAs（D组）或PPIs（E组）。主要终点是与MDs相关的因素以及FD患者胃肠道（GI）症状和MDs的改善情况。
本研究共纳入362例FD患者。发现GI评分高且教育程度低的FD患者易患MDs。在第2周时，B组总体GI症状和抑郁的缓解率显著高于A组和C组[GI：72.72%（32/44）对47.73%（21/44）以及72.72%（32/44）对38.94%（44/113），均<0.05；抑郁：72.22%（26/36）对41.67%（15/36）以及72.22%（26/36）对41.57%（37/89），均<0.05]。此外，E组总体GI症状的缓解率显著高于D组[60.29%（41/68）对42.65%（29/68），<0.05]。在第8周时，这些组观察到相似的疗效和不良反应。
MDs的危险因素是高GI评分和低识字率。因此，针对性治疗（有MDs的患者使用FM+PPIs；无MDs的患者使用PPIs）可提高FD患者的疗效。
