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.

비궤양성 소화불량증 환자의 아형분포에 대한 연구

성인경(In Kyung Sung),강인구(In Ku Kang),심승철(Seung Chul Shim),김종필(Jong Pil Kim),이기창(Kee Chang Lee),손정일(Chong Il Sohn),정철헌(Chul Hun Jung),박동일(Dong Il Park),이종철(Jong Chul Rhee) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

Objectives: It has been proposed that patients with non-ulcer dyspepsia can be classified into symptom subgroups. Subgroups were as follows; those with symptoms suggestive of peptic ulceration (ulcerlike dyspepsia), those with gastric stasis (dysmotilitylike dyspepsia), those with gastroesophageal reflux (refluxlike dyspepsia), and the remainder (unspecified dyspepsia). Methods: The study population consisted of 306 patients with non-ulcer dyspepsia admitted to or attending to Hanyang University Hospital from the beginning of Feb. 1990 to the end of August 1992. We evaluated the gastrointestinal symptoms and measured gastric emptying time for 150min using radionuclide scintiscan of an 99mTc-labeled chicken liver. Results: 1) A total of 306 patients with diagnosed to non-ulcer dyspepsia, 54% had dysmotilitylike dyspepsia, 16% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 10% had unspecified dyspepsia. 2) A total of 148 non-ulcer dyspepsia patients with normal gastric emptying time, 48% had dysmotilitylike dyspepsia, 19% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 10% had unspecified dyspepsia. 3) A total of 158 non-ulcer dyspepsia patients with delayed gastric emptying time, 61% had dysmotilitylike dyspepsia, 14% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 9% had unspecified dyspepsia. 4) Dysmotilitylike dyspepia was more commonly present in patients with delayed gastric emptying time than in patients with normal gastric emptying time(p<0.05) 5) There was a slight female predominance (1:1.3 male-female ratio) in non-ulcer dyspepsia patients with normal gastric emptying and peak incidence was 40 to 49 years of age (40%). 6) There was a female predominance (1:1.9 male-female ratio) in non-ulcer dyspepsia patients with delayed gastric emptying and peak incidence was 40 to 49 years of age(42%). 7) A total of non-ulcer dyspepsia patients, 35% had irritable bowel symptoms and the frequency of accompanied irritable bowel symptoms was statistically significant difference between the patients with normal gastric emptying time (46%) and the patients with delayed gastric emptying time (26%)(p<0.01). Conclusion: Among the non-ulcer dyspepsia patients in Korean, dysmotilitylike dyspepsia was most common subgroup and the refluxlike dyspepsia was very rare and 35% had irritable bowel syptoms.

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.

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 소화불량중에서 위 배출능 검사

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

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.

The Relationship between Obstructive Sleep Apnea and Functional Dyspepsia

구대림,남현우 대한수면연구학회 2020 Journal of sleep medicine Vol.17 No.1

Objectives: Functional dyspepsia is one of the most common functional gastrointestinal disorders. We aimed to investigate the relationship between obstructive sleep apnea (OSA) and functional dyspepsia in patients with the complaint of sleep-disordered breathing. Methods: We prospectively recruited patients who visited the institute for the evaluation of sleep-disordered breathing. All patients underwent overnight polysomnography and submitted their responses to sleep questionnaires. A validated Korean version of the Rome III criteria was used to estimate functional dyspepsia. Functional dyspepsia was classified into two subtypes of epigastric pain syndrome and postprandial distress syndrome. Results: Out of 130 subjects with sleep disturbances, a total of 79 patients (60 men, 19 women) were enrolled. The mean (±standard deviation) age was 46.9±13.4 years. Functional dyspepsia was diagnosed in 8 (10%) patients. Patients with functional dyspepsia showed significantly higher values of Stanford Sleepiness Scale, the proportion of N1 sleep, arousal index, and apnea-hypopnea index compared to patients without functional dyspepsia (p=0.018, p=0.021, p=0.041, and p=0.039, respectively). With respect to OSA severity, 12% of patients with moderate OSA and 22% patients with severe OSA had functional dyspepsia. Severe OSA was significantly associated with a higher proportion of postprandial distress syndrome (p=0.030). Conclusions: Our patients with snoring or OSA revealed that functional dyspepsia is associated with more severe daytime sleepiness and apnea-hypopnea index compared to those without functional dyspepsia. In addition, postprandial distress syndrome was a prevalent subtype of functional dyspepsia in patients with severe OSA.

소화불량(消化不良)과 과심상(過心傷)의 상관성(相關性)에 대(對)한 고찰(考察) -스트레스, 기울(氣鬱), 비병증(脾病證)의 평가(評價)를 통(通)해-

김진성,윤상협,류봉하,류기원,이상욱,Kim, Jin-Sung,Yoon, Sang-Hyub,Ryu, Bong-Ha,Ryu, Ki-Won,Lee, Sang-Wook 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.4

Background & Object : Dyspepsia for which no organic causes are disclosed is referred to as functional dyspepsia. Functional dyspepsia is here studied in connection with a biopsychosocial model. From the aspect of individual response to external environment, in connection with stress response, functional dyspepsia is studied by both the psychology department and the internal medicine departments. The disease is taken as approachable from the aspect of internal injury due to seven emotions and stress as differentiated by Oriental medicine. Materials and Methods : Targeted at 223 patients underwent medical checks and endoscopy at Kangnam Korean Hospital, Kyunghee University. They agreed to join this clinical experiment. Stress response inventory, GARS (global assessment of recent stress scale), GSRS (gastrointestinal symptom rating scale), diagnostic scores for Ki-depression, and Spleen Disease Differentiation of Syndromes were all measured and evaluated. The test group was comprised of functional dyspepsia patients. The control group was comprised of nonsymptomatic chronic gastritis patients who were found to suffer from chronical gastritis in endoscopy and thus could be diagnosed with functional dyspepsia if symptoms would arise, but did not complain of subjective symptoms. Results showed these corelations: Functional dyspepsia patients were found to have more serious Ki-depression compared to nonsymptomatic chronic gastritis patients. The more serious Ki-depression the more serious the dyspepsia symptoms. The higher the stress response inventory the more serious the dyspepsia. Deficiency of spleen Eum, and Deficiency and Sinking of spleen Gi were found to coincide with serious Ki-depression.

Prevalence and Risk Factors for Overlaps between Gastroesophageal Reflux Disease, Dyspepsia, and Irritable Bowel Syndrome: A Population-Based Study

Lee, Soon Young,Lee, Kwang Jae,Kim, Soo Jeong,Cho, Sung Won S. Karger AG 2009 Digestion Vol.79 No.3

<P><I>Background/Aims:</I> People may have symptoms of multiple disorders at the same time. We aimed to determine prevalence and risk factors for overlaps between gastroesophageal reflux disease (GERD), dyspepsia and irritable bowel syndrome (IBS) in a Korean population. <I>Methods:</I> A cross-sectional survey was performed on 1,688 randomly selected Korean subjects. Data on 1,443 subjects could be analyzed. Dyspepsia and IBS were diagnosed using modified Rome II criteria. <I>Results:</I> The prevalences of GERD, dyspepsia and IBS were 8.5, 9.5 and 9.6%. Overlaps between GERD and dyspepsia, GERD and IBS, and dyspepsia and IBS were observed in 2.3 (95% CI 1.4-3.0), 2.0 (95% CI 1.2-2.6%) and 1.3% (95% CI 0.6-1.8%) of the population. 27 and 24% of GERD subjects suffered from dyspepsia and IBS. 24 and 14% of dyspeptic subjects had GERD and IBS. 21 and 14% of IBS subjects had GERD and dyspepsia. Anxiety was significantly associated with GERD overlap (OR 2.73, 95% CI 1.13-6.57), dyspepsia overlap (OR 3.19, 95% CI 1.33-7.63) and IBS overlap (OR 4.92, 95% CI 2.04-11.84), compared with GERD alone, dyspepsia alone and IBS alone. <I>Conclusions:</I> Overlaps between GERD, dyspepsia, and IBS are common in the general population. These overlaps occur predominantly in individuals with anxiety.</P><P>Copyright © 2009 S. Karger AG, Basel</P>

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.

Review : Overlap in Patients With Dyspepsia/Functional Dyspepsia

( Yasuhiro Fujiwara ),( Tetsuo Arakawa ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.4

Patients with dyspepsia/functional dyspepsia (FD) show frequent overlapping of other gastrointestinal (GI) diseases, such as irritable bowel syndrome, and non-GI diseases, in addition to internal subgroup overlapping. These overlap patients have more frequent or more severe symptoms, poorer health-related quality of life and higher somatization scores, and they are more likely to experience anxiety, depression or insomnia compared to non-overlap patients. The higher prevalence of overlap in patients with dyspepsia/FD is not by chance, indicating common pathogeneses, including visceral hypersensitivity, altered GI motility, infection, and stressful early life events. There are few clinical trials targeting overlap in patients with dyspepsia/FD, and no therapeutic strategy has been established. Further studies in this research area are needed. In this review, we describe the epidemiology, pathogenesis and treatment of overlap in patients with dyspepsia/FD.