헬리코박터 제균 3제 요법이 기능성 소화불량증 환자와 소화성 궤양 환자의 증상 호전에 미치는 효과 : 평균 9개월 추적 결과

이은재,감창우,김상수,박태운,홍성일,최창환,한기준,조현근,이재은,김재영 關東大學校 醫科大學 醫科學硏究所 2004 關東醫大學術誌 Vol.8 No.1

Background: The eradication of Helicobacter pylori is approved as an essential therapy in the treatment of the peptic ulcer patients. In the functional dyspepsia patients, H.pylori has been suggested as a causative agent. However, the effectiveness of the eradication therapy is still debated in the treatment of the patients with functional dyspepsia. The purpose of this study was to evaluate the effectiveness of the H. pylori eradication therapy in patients with functional dyspepsia. In this study, we surveyed and compared the degree of symptom between the groups of patients with peptic ulcer disease and functional dyspepsia for nine months on the average after eradication of H. pylori. Methods: The convenience sample consisted of 119 patients with functional dyspepsia and 73 patients with peptic ulcer diseases who had infected by H. pylori. All patients had received eradication therapy of H. pylori for one or two weeks and additional therapy with H2RA or PPI for one to five weeks. After the treatment was completed, the patients were asked every three months about the symptomatic improvements. The degree of symptom was rated on an 1(asymptomatic) to 5(symptomatic, unable to perform ADL) scale. Results : Overall eradication rate of H. pylor was 84.9%(163/192), and there were no significant differences in the eradication rate between the two groups and between one-week and two-week eradication therapies. The mean follow-up periods were nine months. The mean score of the degree of symptom in pre-treatment state was 2.7±0.8 in peptic ulcer disease group and 2.6±0.7 in functional dyspepsia group. The degree of symptom was significantly lowered to 1.3±0.5 in peptic ulcer group (p<0.001) and 1.3±0.4 in functional dyspepsia group(p<0.001) three months after the treatment. The symptomatic improvement in both group was maintained over nine months in most patients(73.9%:76.7%). In addition, the symptomatic improvement in the patients with eradication success was maintained significantly longer than those with eradication failure (p=0.01). Conclusion : In the patients with functional dyspepsia, the symptoms were significantly improved after several weeks of treatment including eradication therpay of H. pylori. In 76.7% of patients with functional dyspepsia, the symptomatic improvement was maintained over nine months. Therefore, the study suggests that the eradication therapy of H.pylori can be one of the therapeutic options in the treatment of patients with functional dyspepsia and that eradication failure may cause the recurrence of the symptom.

기능성 소화불량증에 대한 침치료의 효과 : 무작위배정 대조군 연구

박양춘,조정효,손창규,홍권의,정인철,강위창,최선미 대한침구의학회 2007 대한침구의학회지 Vol.24 No.1

Objectives : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the effect of acupuncture treatment for functional dyspepsia. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of functional dyspepsia. Volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI) and Functional Dyspepsia Quality fo Life(FD-QOL) before and after treatments. Results : 68 subjects finished study. There were not difference between two groups on age, sex, weight, height, severity of dyspepsia, subtype, Byeonjeung, surmise of treatment. After treatment total key symptoms score, improve rate of key symptoms were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment "pressure in upper abdomen" and " cramps in upper abdomen" were more decreased in active acupuncture group compared with sham acupuncture group(p=0.001, p=0.014). After treatment total symptom score and QOL of NDI were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment eating status of FD-QOL in active acupuncture group was significantly increased than sham acupuncture group(p=0.008). After treatment liveliness status of FD-QOL and total score of FDQOL in active acupuncture group was increased than sham acupuncture group though statistically insignificant(p=0.095, p=0.077). Conclusion : Acupuncture treatment is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

기능성 소화불량중에서 위 배출능 검사

이종채(Zhong Chai Lim),나용호(Yong Ho Nah) 대한내과학회 1994 대한내과학회지 Vol.47 No.2

N/A Objectives: Though the patients with functional dyspepsia suffer from variable symptoms, no satisfactory explanation for their complaints can be found. The 5 categories of functional dyspepsia were suggested by the working party on the management of dyspepsia in 1987. The cause of functional dyspepsia is obscure but many reports have shown that about 50% patients with functional dyspeopsia had delayed gastric emptying. There- fore, we evaluated the gastric emptying rate in the subtypes of functional dyspepsia. Method: The gastric emptying study was performed in 30 healthy volunteers and 50 patients with functional dyspepsia. The gastric emptying curves were divided into a lag phase and an emptying phase using the dual phase model. Lag phase was determined by three techniques: 1) inspection of the emptying curve; 2) time to a 2% decrease in stomach activity; and 3) the time of visual appearance of duodenal activity. The patients with functional dyspepsia were categorized on the basis of predominat symptoms as: dysmotility-like dyspepsia, ulcer-like dyspepsia, gastro-esophageal reflux-like dyspepsia, idiopathic dyspepsia, and aerophagia. Results: 1) Functional dyspepsia patients were categorized on the basis of predominant symptoms as: dysmotility-like dyspepsia (n=24), ulcer-like dyspepsia (n=15), gastro-esophageal reflux-like dyspepsia (n=8), idiopathic dyspepsia (n=3). 2) Length of lag perod and half emptying time of solids in normal volunteers were 6.5±4.5 min (95the percentile=15 min) and 98±20 min (95th percentile=120 min). 3) Delayed gastric emptying was confirmed in 38% of patients and only in 3 patients lag period was delayed. There was no correlation between delayed gastric emptying and symptom categories. Conclusion: As above results about 50% patients with functional dyspepsia are categorized as dysmotility-like dyspepsia. There is no difference in the frequency of delayed gastric emptying among the symptom categories and about 38% patients with functional dyspepsia have delayed gastric emptying.

심박변이도(HRV)에서 기능성 소화불량증과 기질성 소화불량증의 상관성 연구

김상헌,김효진,이수정,신철경,이상희,김원일,Kim, Sang-Heon,Kim, Hyo-Jin,Lee, Soo-Jung,Sin, Cheol-Kyung,Lee, Sang-Hee,Kim, Won-Il 대한한방내과학회 2008 大韓韓方內科學會誌 Vol.29 No.2

Objectives : This study was designed to research whether HRV can yield a suitable diagnosis for activity of autonomic nerve system on functional dyspepsia. Methods : The testing of HRV was carried out at the Oriental Medical Center of Dong-Eui University with the participation of 28 functional dyspepsia patients, 25 dyspepsia caused by organic disease patients and 33 control group people. We checked HRV of the three groups for 5 minutes and compared HRV index(frequency domain analysis: HF, LF, VLF, LF/HF Ratio, TP) between groups. Results were as follows : 1. In the frequency domain analysis, HF, LF, VLF, and TP were significantly lower than the control group in the functional dyspepsia patients and dyspepsia caused by organic disease groups. HF, LF, VLF, LF/HF ratio, and TP were not significantly different between functional dyspepsia group and dyspepsia caused by organic disease group. 2. Age in dyspepsia patient group was significantly higher than in the control group. 3. In the frequency domain analysis, LF, VLF, and TP were significantly lower in the functional dyspepsia group than the control group in age 20-30 years. HF, LF, VLF, LF/HF ratio, and TP were not significantly different between the control group and dyspepsia caused by organic disease group in ages 20-30 years. HF, LF, VLF, LF/HF ratio, and TP were not significantly different between functional dyspepsia group and dyspepsia caused by organic disease group in age 20-30 years. Conclusion : According to this study, autonomic nerve system and parasympathetic nerve system decreased more in the functional dyspepsia patient group compared with the control group.

기능성 소화불량 여성환자의 소화불량증과 우울, 건강 관련 삶의 질의 상관관계

배창욱 한국산학기술학회 2022 한국산학기술학회논문지 Vol.23 No.12

This study analyzes the correlation between dyspepsia, depression, and health-related quality of life in patients with functional dyspepsia. The study subjects were diagnosed with functional dyspepsia according to Rome III diagnostic criteria, and data were collected from 153 patients receiving outpatient treatment. The collected data were analyzed with frequency and percentage, mean and standard deviation, T-test, one-way ANOVA, and Pearson's correlation coefficient using the SPSS 18.0 program. The level of statistical significance was set at p<.05. When considering the general characteristics of patients with functional dyspepsia, our study revealed a significant difference according to age, marital status, and occupation. No significant differences were observed for education level and religion. Correlating dyspepsia, depression, and quality of life in functional dyspepsia patients, dyspepsia and depression showed a positive correlation and an inverse correlation, respectively, with quality of life. We further confirmed that functional dyspepsia in patients was associated with dyspepsia, depression, and quality of life. We believe that the results of this study will serve as basic data to improve the quality of life of functional dyspepsia patients by alleviating dyspepsia and reducing depression. 본 연구는 기능성 소화불량 환자의 소화불량증과 우울 및 건강 관련 삶의 질의 상관관계를 분석하는데 있다. 연구대상은 Rome III 진단기준의 기능성 소화불량으로 진단을 받은 대상으로 외래치료 중인 환자 153명에게 서면 동의를 받고 자료를 수집하였다. 분석방법은 SPSS 18.0 프로그램을 사용하여 빈도와 백분율, 평균과 표준편차, T-test, one way ANOVA, Pearson’s correlation coefficient로 분석하였다. 통계적 유의수준은 p<.05로 정하였다. 본 연구의결과는 다음과 같다. 첫째, 기능성 소화불량 환자의 소화불량증이 일반적 특성에서는 연령과 결혼상태, 직업에 따라 유의한 차이가 있었으며, 교육수준과 종교에 따라 유의한 차이는 없었다. 우울과 건강 관련 삶의 질에서는 연령, 결혼상태, 교육수준, 직업, 종교 모든 항목에서 유의한 차가 있었다. 둘째, 기능성 소화불량 환자들의 소화불량증과 우울, 건강 관련삶의 질과의 상관관계에서 소화불량증과 우울은 정의 상관관계를 보였으며 삶의 질과는 부의 상관관계를 보였다. 우울과건강 관련 삶의 질은 부의 상관관계를 보였다. 이는 기능성 소화불량 환자들의 소화불량증과 우울, 건강 관련 삶의 질과상관관계가 있는 것으로 확인되었다. 기능성 소화불량 환자들의 건강 관련 삶의 질을 향상시키기 위해서 소화불량증 개선과 우울 감소를 위한 방안 마련의 기초자료가 될 것으로 사료된다.

한국인의 기능성 소화불량증 환자에서의 증상관찰, 아형분류 및 이에 대한 시사프리드의 효과

최명규 ( Myung Gyu Choi ),최규완 ( Kyu Wan Choi ),김나영 ( Na Young Kim ),임선희 ( Seon Hee Lim ),이계희 ( Kye Heui Lee ),김성국 ( Sung Kook Kim ),최용환 ( Yong Hwan Choi ),송치욱 ( Chi Wook song ),김혜랑 ( Heu Rang Kim ),임창영 ( 대한소화기기능성질환·운동학회 1998 Journal of Neurogastroenterology and Motility (JNM Vol.4 No.1

Background/Aims : The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. Methods . 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. Results . The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. Conclusions . Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.

Current status of functional dyspepsia in Korea

이혁,정혜경,허규찬,Functional Dyspepsia Study Group in the Korean 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.2

Dyspepsia refers to group of commonly occurring upper gastrointestinal symptoms. The majority of patients with dyspepsia suffer from functional (nonulcer)dyspepsia. Although there is a lack of epidemiological data from population-basedor patient cohort studies in Korea, the current understanding of this conditionhas been updated using data from various recent research studies, which have facilitatedthe development of clinical guidelines for functional dyspepsia. Accordingto a survey using the Rome III criteria, more than 40% of respondents whovisited primary clinics and tertiary hospitals were defined as having functionaldyspepsia, most of who were within a subgroup of patients with postprandial distresssyndrome. In addition, a population-based cross-sectional survey revealedconsiderable overlap between functional dyspepsia and other functional gastrointestinaldisorders, including gastroesophageal reflux disease (especially nonerosivereflux disease) and irritable bowel syndrome. In contrast to the results ofWestern trials, there is insufficient evidence to recommend a Helicobacter pyloritest-and-treat strategy as an initial management approach to functional dyspepsiain Korea, suggesting the need for early endoscopic evaluation. Additionalstudies are necessary to adjust the cutoff age for implementation of immediateendoscopic evaluation of patients without alarm symptoms. Considering theprevalence of H. pylori infection and the limited efficacy of symptomatic relief afterits eradication, further well-qualified studies in Korea are warranted.

기능성 소화불량 환자에서 설태후박 및 흉늑각 측정의 진단적 가치

손지영,김진성,Son, Ji-Young,Kim, Jin-Sung 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.2

Objectives : The aims of this study were to evaluate the diagnostic values of tongue coating thickness and sterno-costal angle as the quantitative diagnostic indicators in functional dyspepsia. Methods : We surveyed 60 functional dyspepsia patients recruited by the clinical trial, 'Clinical Trial for Evaluation on Availability of tongue diagnosis system (CTS-1000) : a Pilot study'. The patients were classified into three groups according to Rome III criteria for functional dyspepsia, and categorized into five groups according to Instrument of pattern identification for functional dyspepsia. Nepean dyspepsia index-Korean version (NDI-K) score, tongue coating thickness (percentage of tongue coating by tongue diagnosis system (CTS-1000), and weight of tongue coating by microbalance), sterno-costal angle, duration of illness and body mass index (BMI) were investigated. Results : Among the 5 types by instrument of pattern identification for functional dyspepsia, a significant difference of percentage of tongue coating was found. Percentage of tongue coating and weight of tongue coating showed significant correlation with total NDI-K score. Sterno-costal angle showed strong positive correlation with BMI and also showed significant difference between the non-overweight (BMI<23, n=32) and overweight ($BMI{\geq}23$, n=28) groups. Conclusions : Tongue coating thickness showed its potential as a new quantitative diagnostic indicator of functional dyspepsia. Further studies on the sterno-costal angle are anticipated to evaluate its potential as a new quantitative diagnostic indicator.

Should We Still Subcategorize Helicobacter pylori-Associated Dyspepsia as Functional Disease?

( Kentaro Sugano ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.4

Functional dyspepsia is a group of disorders featuring symptoms believed to be derived from the stomach and duodenum such as upper abdominal discomfort, pain, postprandial fullness and early satiety. A key diagnostic requisite is the absence of organic, metabolic, or systemic disorders to explain "dyspeptic symptoms." Therefore, when peptic ulcer diseases (including scars), erosive esophagitis and upper gastrointestinal malignancies are found at endoscopic examinations, the diagnosis of functional dyspepsia is excluded. One notable exception, however, is Helicobacter pylori infection. According to the Rome III definition, H. pylori infection is included in functional dyspepsia. This is an obvious deviation from the diagnostic principle of functional dyspepsia, since H. pylori infection is a definite cause of mucosal inflammation, which affects a number of important gastric physiologies such as acid secretion, gastric endocrine function and motility. The chronic persistent nature of infection also results in more dramatic mucosal changes such as atrophy or intestinal metaplasia, the presence of which in the esophagus (Barrett`s esophagus) precludes the diagnosis of functional dyspepsia. Since careful endoscopic examination can diagnose reliably H. pylori infection not only in Japan but also in Western contries, it is now feasible and more logical to exclude patients with chronic gastritis caused by H. pylori infection as having dyspeptic symptoms. It is time to establish the Asian consensus to declare that H. pylori infection should be separated from functional dyspepsia. (J Neurogastroenterol Motil 2011;17:366-371)

68명의 기능성 소화불량증 환자에 대한 한의학적 변증분석

박양춘,조정효,최선미,손창규,Park, Yang-Chun,Cho, Jung-Hyo,Choi, Sun-Mi,Son, Chang-Gue 대한한방내과학회 2008 大韓韓方內科學會誌 Vol.29 No.3

Objective : Functional dyspepsia is a common disease impeding subjective quality of life. The present study aimed to analyze syndrome differentiation of functional dyspepsia to help with development of oriental therapeutics. Methods : Sixty-eight subjects diagnosed with functional dyspepsia were analyzed and classified into one of five syndrome differentiations. We compared symptomatic characteristics according to the Nepean Dyspepsia Index (NDI), such as severity, kinds of dyspepsia-related complaints and functional dyspepsia quality of life (QOL) among groups. Results : Patients with disharmony between liver and stomach were most prevalent (52.9%), but no patients with complex of fever and cold. The scores of symptom severity and QOL were not significantly different between groups. Each group had a specified pattern of complaints. Conclusions : Clinical-study based analysis of functional dyspepsia constructed by this study, could be useful in objectively developing Oriental medicines for this disease.