Повышение эффективности диагностики и лечения больных с неэрозивной рефлюксной болезнью, сочетанной с функциональной диспепсией

Abstract

Prezenţa concomitentă a dispepsiei funcţionale (DF) şi a bolii de refl ux neeroziv (BRNE) poartă denumirea de „sindrom încrucişat” (overlap sindrome, DF/BRNE). Drept material de cercetare au servit rezultatele examinării clinice şi ale tratamentului a 175 de pacienţi cu DF/BRNE. Au fost determinate diverse variante clinice ale sindromului încrucişat respectiv. Am determinat că cea mai eficientă schemă de tratament al pacienţilor cu acest sindrom încrucişat este cea care ţine cont de varianta DF/BRNE şi de diversitatea mecanismelor patofiziologice de apariţie a simptomelor maladiei.

The presence of two joint disease, functional dyspepsia (FD) and non-erosive refl ux disease (NERD) at the same time, has been called overlap syndrome, FD/NERD. There are no clear criteria for diagnosing FD/NERD, limited data evidence-based medicine for the treatment with FD/NERD make extremely urgent further study of this disease. The material of the study were the results of clinical examination and treatment of 175 patients with non-erosive reflux disease, combined with functional dyspepsia. Highlighted clinical variants of cross syndrome (FD/NERD) Hp positive and Hp negative, as well as options that are determined at pH monitoring of the esophagus when the clinical symptoms of FD and/or NERD appeared in pathological acid gastroesophageal refl ux (AET+SI+) or physiological acidic gastroesophageal refl ux (AET-SI+). We found that the most effective treatment regimen of patients with cross syndrome (FD/NERD) is a scheme depending on the variant FD/NERD into account the diversity of pathophysiological mechanisms of disease symptoms. The regimens not only improves the clinical manifestations of the disease, but also normalize gastric motility, improve the psycho-emotional status, and normalize the number of episodes of gastroesophageal reflux and gastric function acidogenic.