功能性胃肠道疾病:理解和治疗方面的进展
Christopher J Black1, Douglas A Drossman2, Nicholas J Talley3
1Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Lancet (London, England)
|October 13, 2020
概括
功能性胃肠道疾病,或肠脑相互作用的疾病,影响许多人,并有复杂的原因. 早期诊断和治疗对于患者的福祉和减少医疗负担至关重要.
科学领域:
- 胃肠病学和肠脑轴研究
背景情况:
- 功能性胃肠道疾病 (FGID) 很常见,影响多达40%的人口,常常伴有慢性症状.
- 这些现在被称为肠脑相互作用障碍的疾病, 缺乏明确的有机解释, 涉及复杂的病理生理学.
- 关键因素包括肠脑轴调节失调,微生物失衡,免疫变化,内脏过敏和运动变化.
研究的目的:
- 突出胃肠功能障碍的发生率和影响.
- 强调病理生理学的复杂性以及及时诊断和治疗的重要性.
- 讨论目前的诊断和治疗原则以及未来的个性化方法.
主要方法:
- 诊断依赖于基于症状的标准,合理使用有限的调查.
- 治疗原则以生物心理社会模式为指导,解决身体和心理症状.
- 研究探讨了FGID的肠-大脑轴,微生物失调和免疫功能.
主要成果:
- 由于多次咨询和干预,FGID对生活质量,工作能力和医疗保健系统产生重大影响.
- 心理并发症很常见,但与症状发作的关系尚不清楚.
- 目前的管理重点是症状控制和生物心理社会方法.
结论:
- 由于肠道与大脑相互作用的障碍对社会和经济造成负担,有效的识别和管理至关重要.
- 未来的治疗目标是基于个体病理生理和心理特征的个性化.
- 改善医生沟通和患者教育对于治疗这些慢性疾病至关重要.
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