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目的 :探讨根除幽门螺杆菌 (HP)、改善胃动力及抗焦虑药对HP阳性功能性消化不良 (FD)症状的效果。方法 :HP阳性的FD16 0例随机的分为 3个治疗组 :胶体次枸橼酸铋 (B)合并呋喃唑酮 (F)及羟氨苄青霉素 (A)三联疗法(BFA方案 ,6 0例 )、西沙必利 (CIS ,6 0例 )和多虑平 (DXP ,40例 ) ,对其疗效作前瞻性随机对照研究。结果 :CIS总有效率显著高于BFA(P <0 .0 5 ) ,DXP总有效率介于两者之间。临床类型中 ,CIS对运动障碍型FD疗效优于BFA(P <0 .0 1) ;而对溃疡型FD ,BFA比CIS效果更佳 (P <0 .0 5 ) ;伴有焦虑、多疑、多梦及严重失眠的女性FD ,DXP常常收到良好的效果 ,并优于BFA或CIS(P <0 .0 5 )。不同年龄、性别及病程对疗效亦产生一定的影响。结论 :HP阳性FD没有必要常规行根除HP治疗 ,但对溃疡型FD尤其病程较长者 ,根除HP治疗对改善FD症状有较好的效果。改善胃动力更适合于运动障碍型、年龄较小及病程较短的FD患者。上述治疗无效 ,尤其病程较长且同时伴有神经衰弱征候群的女性FD患者 ,推荐给予抗焦虑药治疗
Objective: To investigate the effect of eradication of Helicobacter pylori (HP), gastric motility and anti-anxiety drugs on symptoms of HP-positive functional dyspepsia (FD). Methods: HP-positive FD16 cases were randomly divided into three treatment groups: colloidal bismuth citrate (B) combined with furazolidone (F) and amoxicillin (A) triple therapy We conducted a prospective randomized controlled study on the effects of plyolide (60 cases) and doxepin (40 cases). Results: The total effective rate of CIS was significantly higher than that of BFA (P <0.05), and the total effective rate of DXP was between the two. The clinical effect of CIS on dyskinesia FD was better than that of BFA (P <0.01), while the effect of ulcerative FD and BFA was better than that of CIS (P <0.05) Women with multiple dreams and severe insomnia, FD and DXP, often received good results and were superior to BFA or CIS (P <0.05). Different age, gender and duration of the effect also have a certain impact. Conclusion: There is no need for HP-positive FD for routine eradication of HP, but for those with longer duration of ulcer-type FD, eradication of HP has better effect on improving FD symptoms. Improve gastric motility is more suitable for dyskinesia, younger and shorter duration of FD patients. The above treatment is ineffective, especially in patients with longer duration and neurasthenia syndrome FD female patients, recommended anti-anxiety treatment