功能性胃肠病罗马3.ppt

功能性胃肠病(FGIDs)  研究进展 姒健敏 FGIDs: 概念 The functional gastrointestinal disorders , defined as a variable combination of chronic or recurrent gastrointestinal symptoms not exp- lained by structural or biochemical abnormalities. Drossman DA, Rome I Rome III Functional Gastrointestinal Disorders A Functional esophageal disorders A1 Functional heartburn A2 Functional chest pain of presumed esophageal origin B Functional gastroduodenal disorders B1 Functional dyspepsia B1a postprandial distress syndrome B1b epigastric pain syndrome C Functional bowel disorders C1 Irritable bowel syndrome C2 Functional bloating C3 Functional constipation C4 Functional diarrhea C5 Unspecified Functional bowel disorder D Functional abdominal pain syndrome E Functional gallbladder and Sphincter of Oddi disorders F Functional anorectal disorders G Functional disorders:neonates and toddlers H Functional disorders:children and adolescents H1 Vomiting and aerophagia H2 Abodminal pain-related functional gastrointestinal disorders H2a FD H2b IBS H2c Abdominal migraine 为什么出现症状的重叠？ - DDW, 2005 人类胃肠道中的5-HT 5-HT1 5-HT3 5-HT4 胃容受性 转运 结肠肠鸣音 感觉 分泌 FGIDs的药物治疗 一 .胃肠动力调节剂 正常胃肠运动基础 特殊排列的平滑肌肌层 自主肌电活动的肌间神经丛 完整的神经内分泌调节系统 胃肠运动的神经内分泌调节 Ach 兴奋性 胃动素 神 TK 胃泌素 SP 前列腺素 激 经 CCK-8 递 ATP 脑啡肽 胰高糖素 素 质 NE 生长抑素 NO VIP 抑制性 胃肠运动失调性疾病 胃肠运动乏力：GERD、FD、胃轻瘫、假性肠梗阻、便秘 胃肠运动紊乱和异常收缩：IBS、环咽部运动障碍综合征、DES、贲门失弛缓症、胡桃夹食管 胃肠运动失调性疾病的治疗