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The Effect of Antidepressant Treatment on Water Loading Test and Hydrocortisone in the Functional Dyspepsia

Author: LiangHuiMin
Tutor: LuYanRu；ChenYuLong
School: Zhengzhou University
Course: Department of Gastroenterology,
Keywords: Functional dyspepsia Water load test Psychological factors Cortisol
CLC: R57
Type: Master's thesis
Year: 2007
Downloads: 109
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Abstract

Functional dyspepsia (Functional Dyspepsia, FD) refers to a group of clinical syndromes, including persistent or recurrent postprandial abdominal discomfort, early satiety, abdominal pain, epigastric burning sensation and no organic disease can be explained by the above symptoms of functional diseases. Symptoms for at least 6 months prior to diagnosis, nearly three months to meet the above criteria. FD pathogenesis is not yet clear, in recent years, studies have shown that functional dyspepsia (FD) is a special pathological, physiological basis of psychosomatic disease. Part of FD patients with mental disorders, especially depression and anxiety symptoms, increasing clinical concern. Rome Ⅱ criteria CCMD3 (classification and diagnosis of mental disorders in China) standard, the topic for observation FD clinical symptoms associated with depression and anxiety status of patients with antidepressant receptive relaxation function of the proximal stomach and some related hormone changes, and further explore the FD pathogenesis and evaluation of the efficacy of antidepressant treatment. Basis the Rome Ⅱ standard and CCMD3 of standards will meet the patients were divided into two groups the FD with depression anxiety, treatment group, 20 cases in the control group of 20 patients, the treatment group received antidepressant medication plus psychotherapy treatment, the control group received conventional inhibition of gastric acid secretion, prokinetic pepsin substance symptomatic treatment. Before and after treatment were symptom score severity assessment HAMD depression scale score measuring the water load test, cortisol, and statistical analysis of the results of the two treatment methods. All the data are used to SPSS10.0 statistical package processing. The count data statistics narrative with M disabilities SD said measurement data statistics narrative percentage (%). P <0.05 was considered statistically significant. Results 1. Symptom score results: the treatment group after antidepressant treatment, gastrointestinal symptoms improved significantly, the symptom score was significantly reduced. The control group after treatment, symptoms improved symptom score did not change significantly, t = 2.692. The treatment group compared with control group gastrointestinal symptoms improve significant differences (P <0.05). 2. HAMD depression scale integration results: the treatment group compared with the control group, HAMD scale score after treatment than before treatment decreased t = 10.833 (P <0.05), the difference was significant. 3. Water load test results: the treatment of the two groups before the water load was no significant difference (P> 0.05). Control group after treatment effective in 5 cases (25%) were cured, 4 patients (20%), 11 cases (55%), the total efficiency 9 cases (45%); effective treatment group and 4 patients (20%) were cured, 13 cases (65%), 3 cases (15%), with a total efficiency of 17 cases (85 per cent). Compared with control group t = -2.154, significant differences (P <0.01). 4. Cortisol test results: the treatment group, 14 cases of cortisol inspection results within the normal range (60-160ng/ml), 6 cases of severe patients with a history of more than 2-5 years, measured cortisol. Four cases of patients with severe to normal, two cases are still high, and the control group, 15 cases in the normal range, five cases of patients with severe cortisol abnormalities after treatment were normal antidepressant treatment, four cases are still higher than normal . Both statistical analysis t = 5.668, P <0.05 two groups with a significant difference. Conclusion 1. FD associated with mental disorder patients symptom scores and HAMD scale score improvement after treatment and scale score decline was related, suggesting an important role of psychological factors in the pathogenesis of FD. 2. The water load with HAMD scale score decreased gradually increased prompt psychological barriers is an important factor to affect the amount of water load, water load test with a fast and safe, simple features, as FD stomach sensitivity check. 3. FD HPA axis function in patients with depression and anxiety associated with severe hyperthyroidism, elevated blood levels of cortisol, neuroendocrine disorders, antidepressant treatment can balance the hyperactivity of the HPA axis function, cortisol levels become normal, so that the water load improved gastric receptive relaxation function, alleviate clinical symptoms. The results show that antidepressant therapy is an effective treatment worthy of clinical application.

The Effect of Antidepressant Treatment on Water Loading Test and Hydrocortisone in the Functional Dyspepsia

Abstract

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