摘要
腹胀是功能性胃肠道疾病(FGIDs)患者的一种常见症状,腹胀具有概念模糊、诊断模糊、发生率高、治疗困难等诸多特点。在目前临床实践中,"早饱"常常被作为腹胀诊断的指标,在罗马Ⅲ诊断标准中,有"早饱"的腹胀属于功能性胃十二指肠疾病中的功能性消化不良(FD)。有文献认为,FD的发病与胃感觉障碍、胃动力障碍密切相关。实际上现有资料提示,胃感觉障碍不能解释FD患者的"早饱"型腹胀症状,同时胃动力障碍也仅可能与一小部分FD患者的"早饱"型腹胀有关。相反,与围进食期有关的胃-结肠反射和头期效应的功能障碍却能解释涵盖各个时相的"早饱"型腹胀。因此,无论有无"早饱",腹胀与结肠功能紊乱的关系比与胃十二指肠功能紊乱的关系更为密切。明确腹胀的诊断,是为了对腹胀做更精准的诊治。另外,情绪障碍通常是功能性腹胀的病因,治疗时要注意对情绪障碍和FGIDs症状作联合治疗。
Abdominal bloating is a common symptom in patients with functional gastrointestinal diseases（ FGIDs）. Abdominal bloating has many features such as conceptual ambiguity,fuzzy diagnosis,high incidence and difficulty in treatment. In current clinical practice, ＂ early satiety＂ is often used as an indicator of abdominal bloating. In Rome III diagnostic criteria,abdominal bloating with ＂ early satiety ＂ belongs to functional dyspepsia（ FD） in functional gastroduodenal diseases. According to the literature,the onset of FD is closely related to gastric sensory disorders and gastric motility disorders. In fact,existing data suggest that gastric sensory disturbances can＇ t explain the ＂ early satiety ＂ type of abdominal bloating symptoms in FD patients,and that gastric dysmotility may be related to ＂ early satiety＂ abdominal bloating in a small group of FD patients. Conversely,dysfunctions of the gastro-colic reflex and head-stage effects associated with encircling feeding periods can explain the ＂ early-satiety＂ type of abdominal bloating that covers all phases. Therefore,whether there is ＂ early satiety＂ or not,abdominal bloating has a more close relationship with colonic disorders than that with gastroduodenal dysfunctions. The clarification of abdominal bloating is aimed at more accurate diagnosis and treatment of bloating. In addition,this article also point out that emotional disorders are often the cause of functional abdominal distension,attentions should be paid to the combination of emotional disorders and FGIDs symptoms in treatment.
作者
邱冬妮
徐三荣
陈玉龙
Qiu Dongni;Xu Sanrong;Chen Yulong(Department of Gastroenterology,Huashan Hospital Affiliated to Hehai University,Shanghai 200040,China;Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华诊断学电子杂志》
2018年第3期157-159,共3页
Chinese Journal of Diagnostics(Electronic Edition)
