关键词: 功能性消化不良, 功能性胃肠病, 罗马Ⅳ标准, 症状和体征, 焦虑, 抑郁

Abstract: Background  Functional dyspepsia（FD） is the most common dyspepsia problem.Symptom overlap and psychosocial abnormalities are very prevalent in FD patients.Current diagnosis of FD is mainly based on the Roman criteria for functional gastrointestinal disorders.Objective  To investigate the symptoms，overlapping symptoms，and mental and psychological conditions in patients with different subtypes of Rome Ⅳ FD .Methods  A total of 172 adult outpatients（≥18 years old） with FD who received medical services in Department of GI Medicine，the First People's Hospital of Wujiang District Affiliated to Nantong University were enrolled from June to December 2017.All of them underwent gastroscopy，and according to the symptom-based results，48 of them were identified with epigastric pain syndrome（EPS），74 with postprandial discomfort syndrome（PDS），and 50 with PDS and EPS.Inductive analysis of symptom composition，overlapping symptoms，and combined anxiety and/or depression status was performed.Results  EPS patients showed lower percentages of postprandial fullness，early satiety，belching and upper abdominal distension，and higher percentage of upper abdominal pain than PDS patients（P<0.017）．Those with EPS and PDS had higher percentages of postprandial fullness early satiety and postprandial nausea or vomiting compared with those with only EPS，and had higher percentages of upper abdominal pain and upper abdominal burning sensation than those with only PDS（P<0.017）．The proportion of those with PDS and EPS with overlapping symptoms was higher than that of those with EPS（P=0.015）．The average total symptom score of patients with EPS was lower than that of patients with PDS（P<0.05）．Those with PDS and EPS had higher average total symptom score than those with PDS or EPS（P<0.05）．The average total symptom score was found to be lower in EPS patients without anxiety symptom and with depressive symptom，or with depressive symptom compared with corresponding subgroups of PDS patients（P<0.05）．The average total symptom score was identified to be higher in patients with both EPS and PDS without anxiety symptom and with depressive symptom，with anxiety symptom and depressive symptom，without anxiety symptom and depressive symptom，with anxiety symptom，or with depressive symptom compared with corresponding subgroups of PDS or EPS patients（P<0.05）．EPS patients with overlapping symptoms showed lower average total symptom score compared with PDS patients with overlapping symptoms（P<0.05）．Those with PDS and EPS had higher average total symptom score than those with only PDS or EPS（P<0.05），which was not influenced by the prevalence of overlapping symptoms.Conclusion  The symptoms of PDS patients are more complicated and serious than those of EPS patients.But when the patients develop both EPS and PDS，the symptoms become even more complicated and severe.

Key words: Functional dyspepsia；Functional gastrointestinal disease；RomeⅣ criteria；Symptoms &, signs；Anxiety；Depression