基于罗马Ⅳ的功能性烧心研究进展  

Research advances in functional heartburn based on RomeⅣcriteria

作　　者：张泰 张北华[2] 马祥雪 王凤云[1] 王萍[1] 唐旭东[3] ZHANG Tai;ZHANG Bei-hua;MA Xiang-xue;WANG Feng-yun;WANG Ping;TANG Xu-dong(Department of Gastroenterology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100091,China;China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院西苑医院脾胃病科,北京100091 [2]中国中医科学院研究生院,北京100700 [3]中国中医科学院,北京100700

出　　处：《海南医学院学报》2022年第22期1755-1760,共6页Journal of Hainan Medical University

基　　金：国家重点研发计划项目(2019YFC1709600)。

摘　　要：烧心是消化系统疾病最常见的胃肠道症状之一。在质子泵抑制剂广泛应用的背景下,仍有大量患者以抑酸治疗后,烧心持续不缓解为主诉就诊,部分被诊断为功能性烧心(functional heartburn,FH)。FH的诊断需要内镜活检术排除嗜酸性食管炎等黏膜异常病变,高分辨食管测压排除食管动力障碍性疾病,以及反流监测证实无反流相关性症状。FH的病理生理学机制仍不明确,可能涉及内脏高敏感和心理应激障碍,其治疗很大程度上仍为经验性治疗,临床医师应尽可能宽慰患者,避免手术治疗。尽管缺乏高质量临床证据支持,神经调节剂、中医药治疗以及心理干预可能是有效的方法。Heartburn is among the most common gastrointestinal symptoms presenting to both generalist physicians and gastroenterologists.In the era of high utilization of proton pump inhibitors,a substantial proportion of patients presenting to the gastroenterologist with chronic symptoms of heartburn do not have a reflux-mediated disease.Subjects without objective evidence of reflux as a cause of their symptoms have functional heartburn(FH).FH has no evidence of abnormal esophageal acid exposure on ambulatory reflux monitoring,major esophageal motor disorders on high resolution manometry,or esophageal mucosal pathology,such as eosinophilic esophagitis on endoscopy with esophageal biopsies.The pathophysiology of FH is unknown but it is often associated with visceral hypersensitivity,and psychiatric disease.Importantly,anti-reflux surgery or other invasive anti-reflux modalities should be avoided.Although there are limited supporting data,modulation of pain perception,traditional Chinese medicine and psychological intervention may be potential therapeutic options in this population.

关 键 词：功能性烧心 食管反流监测 高分辨食管测压 

分 类 号：R571[医药卫生—消化系统]