Pasricha Pankaj J, Talley Nicholas J
Mayo Clinic, Scottsdale, AZ.
University of Newcastle, Newcastle, NSW, Australia.
N Engl J Med. 2026 Jan 8;394(2):166-176. doi: 10.1056/NEJMcp2501860.
Functional dyspepsia is a common but serious medical syndrome that can induce weight loss and food aversion and may be associated with increased risks of hospitalization and death. It probably comprises several different and as yet incompletely characterized disorders. Patients with local mucosal microinflammation driven by an aberrant Th2 response may represent an important subgroup. There is overlap with other gastrointestinal syndromes, particularly irritable bowel syndrome and gastroesophageal reflux disease, and patients with overlap have more severe symptoms. There is no approved drug for functional dyspepsia. Treatment is empirical and directed at symptoms and consists of acid suppressants and low-dose tricyclic antidepressants (and other neuromodulators) along with appropriate nutritional and psychological support.
功能性消化不良是一种常见但严重的医学综合征,可导致体重减轻和食物厌恶,可能与住院和死亡风险增加有关。它可能包含几种不同且尚未完全明确特征的疾病。由异常的Th2反应驱动的局部黏膜微炎症患者可能是一个重要的亚组。与其他胃肠道综合征存在重叠,尤其是肠易激综合征和胃食管反流病,重叠患者的症状更严重。目前尚无获批用于治疗功能性消化不良的药物。治疗是经验性的,针对症状,包括使用抑酸剂和低剂量三环类抗抑郁药(及其他神经调节剂),同时给予适当的营养和心理支持。