Muris J W, Starmans R, Pop P, Crebolder H F, Knottnerus J A
Department of Family Practice, University of Limburg, Maastricht, The Netherlands.
J Fam Pract. 1994 Feb;38(2):139-43.
Family physicians encounter many pitfalls in managing and treating dyspeptic patients, most of whom are treated in family practice based solely on their signs and symptoms.
A computer literature search followed by a systematic methodological appraisal was performed to identify studies that evaluated clinical symptomatology in dyspeptic patients.
Ten studies, none of which took place in a family practice, fulfilled our inclusion criteria. The main conclusion drawn from outpatient populations and patients referred for open-access endoscopy was that certain clusters of symptoms have a negative predictive value for organic causes of dyspepsia. Higher age, male sex, pain at night, relief by antacids or food, and previous history of peptic ulcer disease were identified as predictors of organic causes for abdominal symptoms.
These findings can be helpful to family physicians in determining the need for endoscopy referral. However, since the diagnostic values of tests in family practice may differ from those in referred populations, there is a need for prospective studies in primary care.
家庭医生在管理和治疗消化不良患者时面临许多陷阱，其中大多数患者仅根据其体征和症状在家庭医疗中接受治疗。
进行计算机文献检索，随后进行系统的方法学评估，以识别评估消化不良患者临床症状的研究。
十项研究符合我们的纳入标准，其中没有一项是在家庭医疗环境中进行的。从门诊患者和接受开放式内镜检查转诊的患者中得出的主要结论是，某些症状群对消化不良的器质性病因具有阴性预测价值。年龄较大、男性、夜间疼痛、使用抗酸剂或食物后缓解以及消化性溃疡病史被确定为腹部症状器质性病因的预测因素。
这些发现有助于家庭医生确定是否需要转诊进行内镜检查。然而，由于家庭医疗中检查的诊断价值可能与转诊人群中的不同，因此需要在初级保健中进行前瞻性研究。
