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目的调查功能性胃肠病(FGIDs)患者重叠胃食管反流病(GERD)的发病率。方法收集2006年8~10月解放军总医院消化科门诊FGIDs患者492例,调查其重叠GERD的情况。包括功能性消化不良(FD)、肠易激综合征(IBS)、慢性功能性便秘(CC)、功能性腹泻(F-D)、功能性腹胀(FB)和功能性嗳气(BD)。FGIDs的诊断参照罗马Ⅲ标准;GERD的诊断按照耐信(RDQ)量表,以烧心、胸骨后疼痛感、反酸和反食症状的程度和频度积分≥12分作为判断标准。结果492例FGIDs患者重叠GERD者达73例,重叠率为14.84%。重叠GERD组和无重叠组相比,患者的性别、年龄、病程、居住地、吸烟史及饮酒史差异无统计学意义(P>0.05)。重叠率最高的3种FGIDs依次为FD、CC和IBS。FD患者重叠GERD者21.32%;CC患者重叠GERD者19.35%;12.55%的IBS患者重叠GERD。重叠率最低的FGIDs为BD,重叠率7.69%。302例单一FGIDs患者,重叠GERD者37例,重叠率为12.25%;190例重叠FGIDs患者,重叠GERD者36例,重叠率为18.95%。两组GERD重叠率比较差异有统计学意义(P<0.05)。重叠GERD最多的单一FGIDs为FD,重叠率21.62%;其次为F-D和BD,单一FB未见重叠GERD患者。结论按照罗马Ⅲ诊断标准,FGIDs患者重叠GERD常见。重叠率最高的3种FGIDs依次为FD、CC和IBS,重叠率最低的FGIDs为BD。重叠GERD最多的单一FGIDs为FD,其次为F-D和BD,单一FB未见重叠GERD患者。重叠FGIDs组GERD的重叠率明显高于单一FGIDs组。
Objective To investigate the incidence of overlapping gastroesophageal reflux disease (GERD) in patients with functional gastrointestinal disease (FGIDs). Methods 492 patients with FGIDs from the Department of Gastroenterology, People’s Liberation Army General Hospital from August to October in 2006 were collected to investigate the overlap of GERD. Including functional dyspepsia (FD), irritable bowel syndrome (IBS), chronic functional constipation (CC), functional diarrhea (F-D), functional bloating (FB) and functional purgation (BD). The diagnosis of FGIDs was based on the Rome III criteria. The diagnosis of GERD was based on the RDQ scale with a score of ≥ 12 as a criterion for heartburn, post-sternal pain, and the degree and frequency of acid reflux and anti-trophic symptoms. Results Among 492 FGIDs, there were 73 cases with overlapping GERD, the overlap rate was 14.84%. There were no significant differences in gender, age, course of disease, place of residence, smoking history and drinking history between overlapping GERD group and non-overlapping group (P> 0.05). The three FGIDs with the highest overlap rates were FD, CC and IBS. FD patients overlap GERD 21.32%; CC patients overlap GERD 19.35%; 12.55% of IBS patients overlap GERD. The FGIDs with the lowest overlap rate were BD and the overlap rate was 7.69%. Of the 302 patients with single FGIDs, 37 were overlapped with GERD and the overlap rate was 12.25%. Among 190 patients with overlapping FGIDs, 36 were overlapped with GERD and the overlap rate was 18.95%. There was significant difference in overlap rate of GERD between the two groups (P <0.05). The single FGIDs with the highest GERD were FD with a overlap rate of 21.62%, followed by F-D and BD with no overlap of GERD in a single FB. Conclusion According to Rome Ⅲ diagnostic criteria, overlapping GERD patients with FGIDs are common. The three kinds of FGIDs with the highest overlap rate were FD, CC and IBS in sequence, and the FGIDs with the lowest overlap rate were BD. The single FGIDs with the highest GERD were FD, followed by F-D and BD, with no overlap of GERD in a single FB. Overlap FGIDs group GERD overlap rate was significantly higher than a single FGIDs group.