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

摘要： 背景  功能性消化不良（FD）是消化不良患者的最常见原因，其症状重叠及精神心理异常十分常见，目前FD的诊断主要以功能性胃肠病的罗马标准为依据。目的  了解符合罗马Ⅳ标准的FD不同分型患者的症状、重叠症状及精神心理状况。方法  选取2017年6—12月于南通大学附属吴江区第一人民医院消化内科门诊就诊、18周岁以上接受胃镜检查的FD患者为研究对象，根据症状分型分为上腹痛综合征（EPS）48例、餐后不适综合征（PDS）74例及混合型（PDS重叠EPS）50例。对其症状构成、重叠症状及合并焦虑和/或抑郁状态情况进行归纳分析。结果  EPS患者有餐后饱胀感、早饱、嗳气、上腹胀气症状者占比低于PDS患者，有上腹痛症状者占比高于PDS患者（P<0.017）；混合型患者有餐后饱胀感、早饱、餐后恶心或呕吐症状者占比高于EPS患者，有上腹痛、上腹灼烧感症状者占比高于PDS患者（P<0.017）。混合型患者有重叠症状者占比高于EPS患者（P=0.015）。EPS患者症状总积分低于PDS患者，混合型患者症状总积分高于PDS、EPS患者（P<0.05）。无焦虑状态但有抑郁状态、有抑郁状态EPS患者症状总积分低于PDS患者，无焦虑状态但有抑郁状态、有焦虑状态且有抑郁状态、无焦虑状态且无抑郁状态、有焦虑状态、有抑郁状态混合型患者症状总积分高于PDS、EPS患者（P<0.05）。有重叠症状时，EPS患者症状总积分低于PDS患者；不管有无重叠症状，混合型患者症状总积分高于PDS、EPS患者（P<0.05）。结论  PDS患者较EPS患者的症状更复杂及严重，混合型患者较PDS、EPS患者的症状更复杂及严重。

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