怎样治疗肠胃

如何治疗肠胃配图，仅供参考

Functional Dyspepsia
FD involves complex pathophysiological mechanisms including visceral hypersensitivity,impaired gastric accommodation,delayed gastric emptying,H. pylori infection,psychosocial disorders,and even unhealthy lifestyle.
The primary treatment for FD has been aimed at gastric acid secretion and impaired gut motility. Therefore,prokinetics and acid-inhibitory drugs are the mainstay of treatment for FD. According to a recent network meta-analysis,metoclopramide,trimebutine,mosapride,and domperidone were more effective in treating FD than itopride or acotiamide. However,considering the adverse events related to medications,short-term or alternative use of these drugs could be recommended for the symptomatic relief of FD.
Acid suppression therapy with H2 receptor antagonist or proton pump inhibitor is effective in patients with FD. Numerous clinical trials on proton pump inhibitors demonstrate their favorable effect in FD patients compared to subjects receiving placebos. Acid secretion inhibitors are recommended for patients with EPS,whereas prokinetic agents such as mosapride and acotiamide are recommended for those with PDS.
Buspirone,a 5-HT1A receptor agonist,was the first drug to enhance fundic relaxation and to relieve reduced gastric accommodation. Furthermore,buspirone relieves the symptoms of FD.
Serotonin 5-HT3 receptor antagonists,such as ondansetron and granisetron,act primarily through central and peripheral 5-HT3 receptor blockade.
Acotiamide,a muscarinic M1/M2 receptor antagonist that enhances acetylcholine release,may improve gastric accommodation and dyspeptic symptoms.
Although the role of H. pylori infection in FD has not been fully elucidated,the main mechanisms of symptom development in H. pylori-associated FD were altered gastrointestinal motility and mucosal inflammation. However,therapeutic benefits and symptomatic improvements following H. pylori eradication in patients with FD are not consistent. Nevertheless,H. pylori eradication is an important treatment option because of its curative potential.
Psychosocial factors have been proposed as an important element in the pathophysiology of FD. A recent systematic review showed that psychotropic agents with anxiolytic or antidepressant actions were effective in alleviating FD symptoms. Antidepressant therapy with amitriptyline is useful for FD associated with normal gastric emptying,but not in FD associated with delayed gastric emptying. A meta-analysis of psychotropic agents showed that tricyclic antidepressants showed significant effects compared to the placebo but the risk of adverse events remained. There was no benefit observed over the placebo with selective serotonin reuptake inhibitors or selective norepinephrine reuptake inhibitors.
As a nonpharmacological approach,extensive interventions such as psychotherapy or cognitive therapy may be effective in reducing the symptoms of patients with FD. An Iranian quasi-experimental study showed that cognitive–behavioral stress management strategies were effective in reducing the symptoms of patients with FD. Furthermore,combining psychotherapy and standard medical therapy may improve the short-term outcomes in patients with FD. Brief psychodynamic therapy may improve symptoms,mature defenses,and alexithymia scores in these patients.
Hypnotherapy has been performed as treatment for FD. Hypnotherapy,which is delivered as a structured,multi-session,focused intervention,has been widely used to treat irritable bowel syndrome. However,its therapeutic efficacy in FD remains limited. Although Chiarioni et al. reported significant improvement in symptoms by hypnosis in patients with FD,they observed no correlation with gastric emptying time.
Acupuncture is also effective for FD. While most studies have not been rigorously examined,short-term treatment with acupuncture appears to be effective in reducing symptoms in FD patients.,Herbal medicines with mechanisms of action that have not been clearly identified,several herbal supplements such as rikkunshito (a Japanese herbal medicine that improves gastric emptying),and STW5 (also known as iberogast) were superior to placebo in relation to symptomatic improvement. Overall,convincing data supporting the use of any herbal therapies as treatment for FD are lacking.","department":"