위장운동조절제의 유효성에 영향을 미치는 식습관에 관한 연구
Dietary Behaviors Associated with the Efficacy of Prokinetic Drug in Dyspeptic Patients
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연구배경 소화불량 환자에서 위장운동조절제가 광범위하게 사용되고 있다. 소화불량 환자에서 어떠한 식습관이 위장운동조절제의 유효성에 영향을 미치는지 알아보고자 본 연구를 수행하였다. 방 법 2000년 12월부터 2001년 6월까지 24명의 가정의를 방문한 688명의 소화불량 환자들을 대상으로 itopride를 4주간 투여하고 추적조사 하였다. Itopride 유효성은 투여 2주와 4주에 임상증상, 흡연, 음주, 스트레스 및 식습관에 대한 항목이 포함된 구조화된 설문지를 이용하여 평가하였다. 결 과 4주 치료 후 증상이 중등도 이상 개선된 396명(57.6%)의 환자는 유효군으로, 증상개선이 미약하거나 없는 292명(42.4%)의 환자는 비유효군으로 분류하였다. 다변량분석 결과 하루 중 불규칙한 식사횟수(OR 1.81, 95% CI: 1.07, 3.06)와 주당 불규칙한 식사를 하는 일수(OR 2.07, 95%CI: 1.24, 3.45)가 많을수록 itopride의 유효성이 적은 것으로 나타났다. 반면에 음주, 흡연, 스트레스, 과식의 빈도, 자극적인 음식섭취, 식사속도 및 아침결식은 itopride의 유효성과 관련이 없었다 결 론 본 연구결과에 의하면 불규칙한 식사 습관이 위장운동조절제의 유효성을 낮추는 것으로 나타났다. 따라서 소화불량환자에서 위장운동조절제의 유효성을 높이기 위해서는 규칙적인 식습관이 권장된다.
Abstract
Background We sought to determine whether dietary behaviors are associated with the efficacy of prokinetic drug in dyspeptic patients. Methods From December 2000 to June 2001, 688 patients with dyspepsia were treated with itopride for 4 weeks by 24 family physicians. Itopride efficacy was determined by follow-up during weeks 2 and 4 at which time, using a structured questionnaire, patients were assessed on symptoms, as well as smoking, alcohol, stress and dietary behaviors. Results At the end of the 4 week treatment, moderate to complete relief of symptoms was reported by 396 patients (57.6%, affected group), whereas 292 (42.4%, unaffected group) reported slight or no improvement. Factors associated with poor efficacy of itopride included irregular meal frequency per day (OR 1.81, 95% CI: 1.07, 3.06) and irregularity of mealtime per week (OR 2.07, 95%CI: 1.24, 3.45). Factors not associated with efficacy included alcohol consumption, smoking, stress, frequency of overeating, consumption of spicy foods, pace of eating, and skipping breakfast. Conclusions Irregular eating patterns were significantly associated with the poor efficacy of prokinetic drug in dyspeptic patients. To increase the efficacy of prokinetic drug, patients should be advised to eat regularly and at set times.
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