饮食管理联合运动疗法对功能性消化不良患者的康复效果

doi:10.3877/cma.j.issn.2095-2015.2025.04.021

目的

本研究旨在评估饮食管理联合运动疗法对功能性消化不良（FD）患者康复效果的应用价值。

方法

前瞻性选取2021年3月至2024年3月于太和县人民医院确诊为功能性消化不良的患者161例，筛选后最终纳入100例，随机分为对照组（接受常规治疗）50例和观察组（在常规治疗的基础上接受饮食管理联合运动疗法）50例。采用罗马IV标准进行临床疗效评价，并记录患者临床症状消失时间；检测患者胃泌素、胃动素和生长抑素（SS）水平，使用尼平消化不良指数（NDI）和匹兹堡睡眠质量指数（PSQI）量表评估生活质量和睡眠质量。

结果

干预后，观察组的餐后饱胀、早饱感、上腹部疼痛和上腹部灼热感评分均显著低于对照组；观察组的胃泌素、胃动素高于对照组，SS水平低于对照组。观察组干预后的症状指数（NDSI）显著低于对照组，而生活质量指数（NDLQI）显著高于对照组。此外，观察组干预后的PSQI评分显著低于对照组。

结论

饮食管理联合运动疗法可有效提升FD患者的临床疗效和康复效果，缩短症状消失时间，改善胃肠激素水平，提高生活质量和睡眠质量，可作为常规康复治疗的补充。

关键词: 功能性消化不良, 饮食管理, 运动疗法, 康复效果, 生活质量, 睡眠质量

Objective

To evaluate the application value of dietary management combined with exercise therapy in the rehabilitation of patients with functional dyspepsia (FD).

Methods

A total of 161 patients diagnosed with functional dyspepsia at Taihe County People's Hospital from March 2021 to March 2024 were prospectively selected, with 100 patients meeting the inclusion criteria. They were randomly assigned to the control group (50 cases, receiving routine treatment) and the observation group (50 cases, receiving dietary management combined with exercise therapy in addition to routine treatment). Clinical efficacy was assessed using the Rome Ⅳ Criteria, and the time to symptom resolution was recorded. Gastrin, motilin, and somatostatin (SS) levels were measured. The Nipin Indigestion Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate quality of life and sleep quality.

Results

In terms of clinical efficacy, the postprandial bloating, early satiety, upper abdominal pain, and upper abdominal burning sensation scores in the observation group were significantly lower than those in the control group. Regarding the resolution time of clinical symptoms, the recovery time for each symptom in the observation group was significantly shorter than that in the control group. After intervention, the gastrin and motilin of the observation group were higher than those of the control group, and the SS level was lower than that of the control group. The symptom index (NDSI) of the observation group after intervention was significantly lower, while the quality of life index (NDLQI) was significantly higher compared to the control group. Additionally, the PSQI score of the observation group was significantly lower than that of the control group after the intervention.

Conclusion

Dietary management combined with exercise therapy can effectively enhance the clinical efficacy and rehabilitation outcomes for FD patients, shorten symptom resolution time, improve gastrointestinal hormone levels, and enhance both quality of life and sleep quality. It can be used as a beneficial supplement to routine rehabilitation treatment.

Key words: Functional dyspepsia, Dietary management, Exercise therapy, Rehabilitation outcomes, Quality of life, Sleep quality

表1 两组临床疗效评分比较（分，

± s）

组别	例数	餐后饱胀	早饱感	上腹部疼痛	上腹部灼热感
对照组	50	2.22±0.67	2.00±0.45	1.66±0.35	1.68±0.38
观察组	50	1.25±0.38	1.05±0.30	1.02±0.28	0.92±0.25
t		8.91	12.42	10.10	11.81
P		<0.001	<0.001	<0.001	<0.001

表1 两组临床疗效评分比较（分，

± s）

组别	例数	餐后饱胀	早饱感	上腹部疼痛	上腹部灼热感
对照组	50	2.22±0.67	2.00±0.45	1.66±0.35	1.68±0.38
观察组	50	1.25±0.38	1.05±0.30	1.02±0.28	0.92±0.25
t		8.91	12.42	10.10	11.81
P		<0.001	<0.001	<0.001	<0.001

表2 两组临床症状消失时间比较（d，

± s）

组别	例数	腹痛	腹胀	食欲不振	恶心
对照组	50	15.41±3.25	12.67±2.52	24.62±2.65	12.50±1.68
观察组	50	11.50±2.56	9.10±1.34	19.14±2.16	8.92±1.45
t		6.68	8.85	11.33	11.41
P		<0.001	<0.001	<0.001	<0.001

表2 两组临床症状消失时间比较（d，

± s）

组别	例数	腹痛	腹胀	食欲不振	恶心
对照组	50	15.41±3.25	12.67±2.52	24.62±2.65	12.50±1.68
观察组	50	11.50±2.56	9.10±1.34	19.14±2.16	8.92±1.45
t		6.68	8.85	11.33	11.41
P		<0.001	<0.001	<0.001	<0.001

表3 两组胃肠激素水平比较（

± s）

组别	例数	胃泌素(ng/L)		胃动素(pg/mL)		生长抑素(pg/mL)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	50	68.54±5.33	99.45±10.51^*	89.74±8.97	130.77±11.45^*	62.52±6.31	47.62±6.39^*
观察组	50	67.96±5.48	135.77±12.30^*	89.53±8.69	174.86±12.65^*	61.63±5.95	39.28±5.17^*
t		0.54	15.87	0.12	18.27	0.73	7.18
P		0.593	<0.001	0.906	<0.001	0.470	<0.001

表3 两组胃肠激素水平比较（

± s）

组别	例数	胃泌素(ng/L)		胃动素(pg/mL)		生长抑素(pg/mL)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	50	68.54±5.33	99.45±10.51^*	89.74±8.97	130.77±11.45^*	62.52±6.31	47.62±6.39^*
观察组	50	67.96±5.48	135.77±12.30^*	89.53±8.69	174.86±12.65^*	61.63±5.95	39.28±5.17^*
t		0.54	15.87	0.12	18.27	0.73	7.18
P		0.593	<0.001	0.906	<0.001	0.470	<0.001

表4 两组尼平消化不良指数比较（分，

± s）

组别	例数	症状指数		生活质量指数
组别	例数	干预前	干预后	干预前	干预后
对照组	50	66.55±8.40	34.51±6.38^*	59.35±7.11	70.48±7.75^*
观察组	50	65.87±7.79	29.60±5.66^*	61.05±8.30	77.82±8.81^*
t		0.42	4.07	1.10	6.30
P		0.676	<0.001	0.274	<0.001

表4 两组尼平消化不良指数比较（分，

± s）

组别	例数	症状指数		生活质量指数
组别	例数	干预前	干预后	干预前	干预后
对照组	50	66.55±8.40	34.51±6.38^*	59.35±7.11	70.48±7.75^*
观察组	50	65.87±7.79	29.60±5.66^*	61.05±8.30	77.82±8.81^*
t		0.42	4.07	1.10	6.30
P		0.676	<0.001	0.274	<0.001

表5 两组睡眠质量比较（分，

± s）

组别	例数	匹兹堡睡眠质量指数
组别	例数	干预前	干预后
对照组	50	10.83±1.28	6.40±1.05^*
观察组	50	11.05±1.19	4.23±0.64^*
t		0.89	12.48
P		0.376	<0.001

表5 两组睡眠质量比较（分，

± s）

组别	例数	匹兹堡睡眠质量指数
组别	例数	干预前	干预后
对照组	50	10.83±1.28	6.40±1.05^*
观察组	50	11.05±1.19	4.23±0.64^*
t		0.89	12.48
P		0.376	<0.001

[1]	Oshima T. Functional Dyspepsia: Current Understanding and Future Perspective[J]. Digestion, 2024, 105(1): 26-33.
[2]	Black CJ, Paine PA, Agrawal A, et al. British Society of Gastroenterology guidelines on the management of functional dyspepsia[J]. Gut, 2022, 71(9): 1697-1723.
[3]	Duncanson K, Burns G, Pryor J, et al. Mechanisms of Food-Induced Symptom Induction and Dietary Management in Functional Dyspepsia[J]. Nutrients, 2021, 13(4): 1109.
[4]	Hu N, Wang K, Zhang L, et al. Epidemiological and clinical features of functional dyspepsia in a region with a high incidence of esophageal cancer in China[J]. Chin Med J(Engl), 2021, 134(12): 1422-1430.
[5]	Wuestenberghs F, Melchior C, Desprez C, et al. Sleep Quality and Insomnia Are Associated With Quality of Life in Functional Dyspepsia[J]. Front Neurosci, 2022, 16: 829916.
[6]	Yang NN, Tan CX, Lin LL, et al. Potential Mechanisms of Acupuncture for Functional Dyspepsia Based on Pathophysiology[J]. Front Neurosci, 2022, 15: 781215.
[7]	Long YQ, Xu WL, Li LX, et al. Characteristics and Risk Factors of Functional Dyspepsia Fulfilling the Rome IV Criteria Overlapping With Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, and Functional Constipation in South China[J]. J Neurogastroenterol Motil, 2024, 30(2): 184-193.
[8]	Wauters L, Dickman R, Drug V, et al. United European Gastroenterology(UEG) and European Society for Neurogastroenterology and Motility(ESNM) consensus on functional dyspepsia[J]. United European Gastroenterol J, 2021, 9(3): 307-331.
[9]	Fitzpatrick JA, Melton SL, Yao CK, et al. Dietary management of adults with IBD-the emerging role of dietary therapy[J]. Nat Rev Gastroenterol Hepatol, 2022, 19(10): 652-669.
[10]	Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene[J]. Prog Cardiovasc Dis, 2023,77:59-69.
[11]	陈德艺, 韦良宏, 陈海东, 等. 运动疗法对功能性消化不良伴焦虑、抑郁患者的效果[J]. 内科, 2023, 18(2): 127-130.
[12]	Jurado-Fasoli L, De-la-O A, Molina-Hidalgo C, et al. Exercise training improves sleep quality: A randomized controlled trial[J]. Eur J Clin Invest, 2020, 50(3): e13202.
[13]	Caballero-Mateos AM, Redondo Cerezo E. Dyspepsia, functional dyspepsia and Rome IV criteria[J]. Rev Esp Enferm Dig, 20,110(8):530-531.
[14]	Fang XC, Lin ZH, Wu YD,et al. Treatment of functional dyspepsia in Chinese adult patients with domperidone: A multicenter, randomized, double-blind, placebo-controlled pilot study[J]. J Dig Dis, 2023, 24(11):603-610.
[15]	屈军原. 功能性消化不良患者饮食教育的效果分析[J]. 中国食品工业, 2023(10): 121-123.
[16]	李岩, 姚鑫洁. 饮食因素对功能性消化不良的影响[J]. 中国中西医结合消化杂志, 2023, 31(10): 747-750.
[17]	苏秀萍, 陈玲红, 连丽凤, 等. 认知行为干预联合运动疗法应用于FD患者的效果[J]. 中国医学创新, 2023, 20(7): 93-97.
[18]	柳红良, 白宇宁. 基于罗马Ⅳ标准探讨功能性消化不良中西医心身诊疗思路[J]. 中国临床医生杂志, 2021, 49(10): 1138-1141.
[19]	Talley NJ, Haque M, Wyeth JW, et al. Development of a new dyspepsia impact scale: The Nepean Dyspepsia Index[J]. Aliment Pharmacol Ther, 1999, 13(2): 225-235.
[20]	Aloba OO, Adewuya AO, Ola BA, et al. Validity of the Pittsburgh Sleep Quality Index(PSQI) among Nigerian university students[J]. Sleep Medicine, 2007, 8(3): 266-270.
[21]	Lee K, Kwon CI, Yeniova AÖ, et al. Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis[J]. Sci Rep, 2024, 14(1): 4172.
[22]	Sayuk GS, Gyawali CP. Functional Dyspepsia: Diagnostic and Therapeutic Approaches[J]. Drugs, 2020, 80(13): 1319-1336.
[23]	Wang C, Fang X. Inflammation and Overlap of Irritable Bowel Syndrome and Functional Dyspepsia[J]. J Neurogastroenterol Motil, 2021, 27(2): 153-164.
[24]	Miwa H, Nagahara A, Asakawa A, et al. Evidence-based clinical practice guidelines for functional dyspepsia 2021[J]. J Gastroenterol, 2022, 57(2): 47-61.
[25]	Liptak P, Duricek M, Schnierer M,et al. Symptoms of functional dyspepsia and irritable bowel syndrome among medical students in Slovakia and their relation to diet and exercise[J]. Eur J Gastroenterol Hepatol, 2024,36(8):985-992.
[26]	Duboc H, Latrache S, Nebunu N, et al. The Role of Diet in Functional Dyspepsia Management[J]. Front Psychiatry, 2020,11:23.
[27]	Huang HB, Gong W, Hou YY, et al. Mucoadhesive Hydrogel with Anti-gastric Acid and Sustained-Release Functions for Amelioration of DSS-Induced Ulcerative Colitis[J]. J Agric Food Chem, 2023, 71(9): 4016-4028.
[28]	Fuchs KH, Meining A. Current Insights in the Pathophysiology of Gastroesophageal Reflux Disease[J]. Chirurgia(Bucur), 2021, 116(5): 515-523.
[29]	Sorbye H, Meyer LS, Mordal KE, et al. Patient reported symptoms, coping and quality of life during somatostatin analogue treatment for metastatic small-intestinal neuroendocrine tumours[J]. Health Qual Life Outcomes, 2020, 18(1): 188.
[30]	刘伟, 王艳, 张永刚, 等. 益生菌强化肠内营养结合饮食指导对老年胃肠疾病术后胃肠功能康复的影响[J]. 中国微生态学杂志, 2024, 36(1): 80-84.

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Rehabilitation effect of dietary management combined with exercise therapy on patients with functional dyspepsia

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Rehabilitation effect of dietary management combined with exercise therapy on patients with functional dyspepsia