生物反馈电刺激联合补中益气汤、针刺对Ⅰ、Ⅱ度直肠脱垂患者盆底肌功能及肛门直肠动力学影响分析
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摘要
目的:观察生物反馈电刺激联合补中益气汤、针刺对Ⅰ、Ⅱ度直肠脱垂患者盆底肌功能及肛门直肠动力学影响。方法:选取2015年10至2017年10月间在本院接受治疗Ⅰ度及Ⅱ度直肠脱垂患96例,依据随机数字表法将其分成两组,对照组(48例)使用生物反馈进行治疗,观察组(48例)在对照组基础上联合针刺和补中益气汤治疗;观察患者临床治疗效果、治疗前后一次排便时长、一周排便次数、肛肠动力学相关指标改变状况,评估患者肛门坠胀程度和直肠脱出状况。结果:观察组总的有效率为91.67%,高于对照组的70.83%,差异有统计学意义(P<0.05);治疗后观察组肛管最大收缩压、直肠最大容受阀值及直肠感知阀值高于对照组,肛管静息压低于对照组,差异均有统计学意义(P<0.05);治疗后患者肛门坠胀评分、直肠脱出评分及一次排便时长较治疗前均显著降低,一周排便次数增加,差异有统计学意义(P<0.05),且观察组效果更佳。结论:生物反馈电刺激结合补中益气汤、针刺可显著改善直肠脱垂患者临床症状和排便质量,临床效果显著,值得进一步推广使用。
Objective:To analyze the effect of biofeedback electrical stimulation combined with Buzhong Yiqi Decoction and acupuncture on pelvic floor muscle function and anorectal dynamics in patients with I and Ⅱ degree rectal prolapse.Methods:From October 2015 to October 2017 in our hospital for treatment of I degree and Ⅱ degree rectal prolapse patients of 96 cases,according to randomly divided into two groups,the controlled group(48 cases) using biofeedback treatment,the observation group(48 cases) in the control group based on the combined acupuncture and Buzhong Yiqi Decoction in the treatment of patients before and after treatment.Clinical treatment,to observe the first defecation time,relevant indicators of a week defecation frequency,anorectal dynamic condition,assessment of patients with anal bulge and rectal prolapse condition.Results:In the observation group,the total effective rate was 91.67%,higher than 70.83% in the controlled group,the difference was statistically significant(P < 0.05).Ater treatment,the observation group anal maximal systolic blood pressure,rectal maximum receptivity and rectal perception threshold threshold was higher than the controlled group,the anal resting pressure lower than the controlled group,the differences were statistically significant(P < 0.05).After treatment of patients with anal bulge score,rectal prolapse score and a defecation time were significantly lower than before treatment,one week defecation times increased,the difference was statistically significant(P < 0.05),and the observation group was better.Conclusion:Biofeedback electric stimulation combined with Buzhong Yiqi Decoction and acupuncture can significantly improve the clinical symptoms and defecation quality of patients with rectal prolapse,and the clinical effect is remarkable,which is worthy of further promotion and application.
Objective:To analyze the effect of biofeedback electrical stimulation combined with Buzhong Yiqi Decoction and acupuncture on pelvic floor muscle function and anorectal dynamics in patients with I and Ⅱ degree rectal prolapse.Methods:From October 2015 to October 2017 in our hospital for treatment of I degree and Ⅱ degree rectal prolapse patients of 96 cases,according to randomly divided into two groups,the controlled group(48 cases) using biofeedback treatment,the observation group(48 cases) in the control group based on the combined acupuncture and Buzhong Yiqi Decoction in the treatment of patients before and after treatment.Clinical treatment,to observe the first defecation time,relevant indicators of a week defecation frequency,anorectal dynamic condition,assessment of patients with anal bulge and rectal prolapse condition.Results:In the observation group,the total effective rate was 91.67%,higher than 70.83% in the controlled group,the difference was statistically significant(P < 0.05).Ater treatment,the observation group anal maximal systolic blood pressure,rectal maximum receptivity and rectal perception threshold threshold was higher than the controlled group,the anal resting pressure lower than the controlled group,the differences were statistically significant(P < 0.05).After treatment of patients with anal bulge score,rectal prolapse score and a defecation time were significantly lower than before treatment,one week defecation times increased,the difference was statistically significant(P < 0.05),and the observation group was better.Conclusion:Biofeedback electric stimulation combined with Buzhong Yiqi Decoction and acupuncture can significantly improve the clinical symptoms and defecation quality of patients with rectal prolapse,and the clinical effect is remarkable,which is worthy of further promotion and application.
引文
[1] 王金果,李伟,李鹏.针刺联合生物反馈电刺激治疗脑卒中后尿失禁疗效分析[J].河北中医药学报,2014,29(4):31～32
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[11] 王珊珊,白田雨,刘敏,等.肌电生物反馈和针刺结合康复功能训练治疗脑卒中后吞咽障碍的临床疗效观察[J].中华物理医学与康复杂志,2014,36(2):129～131
[12] Boryckakiciak K,Wawiernia K,Namys?J,et al.Role of electromyography and functional electrical stimulation in the treatment of anorectal diseases.[J].Polish Journal of Surgery,2015,87(4):194～202
[13] 马兆哲,于永铎.生物反馈联合针灸及化瘀通便汤对盆底失弛缓型便秘的治疗效果[J].贵阳医学院学报,2017,42(3):341～343
[14] 鲍劲松,童光磊,周陶成,等.针刺结合肌电生物反馈对痉挛性脑瘫患儿智力及运动功能的影响[J].四川中医,2017,10(8):183～186
[15] 丁康.针刺结合生物反馈治疗62例功能性肛门直肠痛疗效观察[J].中医药信息,2013,30(2):78～80
[2] 王红新,谷敏.生物反馈电刺激联合针刺治疗女性产后性功能障碍疗效观察[J].山东医药,2014,16(23):68～69
[3] 唐虹,杨廷彦,常有军,等.盆底肌生物反馈和电刺激联合针刺治疗脊髓损伤后神经源性膀胱的疗效[J].贵阳医学院学报,2016,41(11):1314～1317
[4] Kuo L J,Lin Y C,Lai C H,et al.Improvement of Fecal Incontinence and Quality of Life by Electrical Stimulation and Biofeedback for Patients With Low Rectal Cancer After Intersphincteric Resection[J].Archives of Physical Medicine Rehabilitation,2015,96(8):1442～147
[5] 孙立明.生物反馈穴位刺激对脑卒中后上肢功能的康复作用[J].中西医结合心脑血管病杂志,2017,15(15):1826～1828
[6] 唐新辉,尚淑梅,李春玲,等.肌电生物反馈联合针刺对脑卒中偏瘫患者上肢功能的影响[J].中西医结合心脑血管病杂志,2014,3(5):535～537
[7] Hill S R,Ehrlich P F,Felt B,et al.Rectal prolapse in older children associated with behavioral and psychiatric disorders[J].Pediatric Surgery International,2015,31(8):719～724
[8] 关露春,龙再菊.针刺配合生物反馈疗法在盆底失弛缓综合征中的应用[J].中国中西医结合消化杂志,2015,9(6):408～410
[9] Tennakoon A,Farook G.PWE-380Safety and efficacy of laparoscopic ventral mesh rectopexy and sacrocolpopexy for rectal prolapse and obstructed defecation:analysis of first 20cases at a uk district general hospital[J].Gut,2015,4(1):62～64
[10] 谷艳侠,郭永禄,尹伟华,等.针刺联合电子生物反馈治疗对脑血管病患者运动功能的影响[J].现代中西医结合杂志,2015,24(29):3224～3226
[11] 王珊珊,白田雨,刘敏,等.肌电生物反馈和针刺结合康复功能训练治疗脑卒中后吞咽障碍的临床疗效观察[J].中华物理医学与康复杂志,2014,36(2):129～131
[12] Boryckakiciak K,Wawiernia K,Namys?J,et al.Role of electromyography and functional electrical stimulation in the treatment of anorectal diseases.[J].Polish Journal of Surgery,2015,87(4):194～202
[13] 马兆哲,于永铎.生物反馈联合针灸及化瘀通便汤对盆底失弛缓型便秘的治疗效果[J].贵阳医学院学报,2017,42(3):341～343
[14] 鲍劲松,童光磊,周陶成,等.针刺结合肌电生物反馈对痉挛性脑瘫患儿智力及运动功能的影响[J].四川中医,2017,10(8):183～186
[15] 丁康.针刺结合生物反馈治疗62例功能性肛门直肠痛疗效观察[J].中医药信息,2013,30(2):78～80