功能性消化不良的罗马Ⅳ标准解读

被引：128

作者：

孙晓红

机构：

[1] 北京,中国医学科学院北京协和医学院北京协和医院消化科

来源：

中华全科医师杂志 | 2017年 / 16卷 / 09期

关键词：

消化不良; 诊断; 标准;

D O I：

暂无

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

与罗马Ⅲ分类及诊断标准相比较, 罗马Ⅳ对功能性消化不良(FD)总体上调整不多。FD诊断标准时限仍定为病程超过6个月, 近3个月有症状发作, 餐后饱胀、早饱、上腹痛、上腹部烧灼感4个核心症状的程度影响日常生活, 根据症状与进餐关系, FD人分为餐后不适综合征和上腹痛综合征两个亚型。临床上推荐胃镜检查, 但不常规推荐胃功能评估。调节生活方式是治疗FD的基础;根据FD亚型可经验性选择抑酸药物治疗或促动力剂治疗;根除Hp治疗可使患者长期获益;对于难治性FD患者推荐抗焦虑抑郁药物治疗。

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