Flupentixol/melitracen for epigastric pain syndrome in female patients with abnormal urinalysis and therapeutic insights into the brain–bladder axis

The pathogenesis of abnormal urinalysis in female epigastric pain syndrome (EPS) is unclear. This study aimed to observe the effect of flupentixol/melitracen (FM) acting in central nervous system on urinalysis in female EPS. It is confirmed that abnormal urinalysis indicators may be related to somatization caused by abnormal brain-bladder axis. A total of 125 female patients with EPS were randomly assigned to the test and control groups. Patients in the control group (n = 62) received omeprazole for 4 weeks. On this basis, cases in the test group (n = 63) received FM. The changes of dyspepsia symptoms, somatization symptoms and urinalysis were observed at 0 and 4 weeks. In this clinical trial, the score of DSS, somatization symptoms and urinary inflammatory indicators could improve after received FM in female EPS patients with abnormal urinalysis indicators. These results suggest that the brain-bladder axis might contribute to the pathogenesis of EPS, combined with effective anti-somatization or anti-depression treatment is necessary in some female EPS patients with abnormal urinalysis. Further studies are needed to confirm about brain-gut-bladder axis in EPS pathogenesis. Clinical Trials.gov (number: ChiCTR2400079677).