补气活血法联合生物反馈治疗排便推力不足型功能性排便障碍的疗效评价
|
摘要
【目的】评价补气活血法联合生物反馈治疗排便推力不足型功能性排便障碍(FDD-IDP)的疗效。【方法】将41例FDDIDP患者随机分为治疗组20例和对照组21例,对照组给予生物反馈治疗,治疗组给予补气活血法联合生物反馈治疗,疗程均为20 d。比较2组患者治疗前后症状评分、便秘结局量表(PRO)评分、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、便秘生活质量量表(PAC-QOL)评分、肛门直肠测压和盆底肌电测量结果,并评价2组疗效。【结果】(1)治疗20 d后,治疗组的总有效率为85.00%,对照组为52.38%,治疗组的疗效明显优于对照组(P<0.05)。(2)与治疗前相比较,对照组和治疗组在治疗后患者的症状评分、PRO评分、SAS和SDS评分、PAC-QOL评分、肛门直肠测压和盆底肌电测量结果等均得到改善(P<0.05或P<0.01),且治疗组治疗后对上述指标的改善作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。【结论】生物反馈治疗对FDD-IDP具有较好疗效,补气活血法联合生物反馈治疗的疗效优于单纯生物反馈治疗。
Objective To evaluate the clinical effect of Qi-tonifying and blood-activating therapy combined with biofeedback therapy on functional defecation disorders(FDD)with inadequate defecatory propulsion(IDP).Methods Forty-one cases of FDD-IDP patients were randomly divided into treatment group(n=20)and control group(n=21).The control group was given biofeedback therapy,and the treatment group was given Qi-tonifying and blood-activating therapy combined with biofeedback therapy,the treatment covering 20 d.Before and after treatment,the scores of symptoms,patient-reported outcomes(PRO),Self-rating Anxiety Scale(SAS),Selfrating Depression Scale(SDS)and Patient Assessment of Constipation Quality of Life(PAC-QOL)as well as the parameters of anorectal manometry and pelvic floor electrophysiological measurement in the two groups were detected.And after treatment,the therapeutic effect of the two groups was evaluated.Results(1)After treatment for 20 d,the total effective rate of the treatment group(85.00%)was higher than that of the control group(52.38%),and the difference was statistically significant(P<0.05).(2)Compared with those before treatment,the scores of symptoms,PRO,SAS,SDS and PAC-QOL as well as the parameters of anorectal manometry and pelvic floor electrophysiological measurement in the two groups were improved after treatment(P<0.05 or P<0.01),and the improvement in the treatment group was superior to that in the control group,the difference being statistically significant(P<0.05 or P<0.01).Conclusion Biofeedback therapy has a good effect on FDD-IDP,and its combination with Qi-tonifying and blood-activating therapy can enhance the therapeutic effect.
Objective To evaluate the clinical effect of Qi-tonifying and blood-activating therapy combined with biofeedback therapy on functional defecation disorders(FDD)with inadequate defecatory propulsion(IDP).Methods Forty-one cases of FDD-IDP patients were randomly divided into treatment group(n=20)and control group(n=21).The control group was given biofeedback therapy,and the treatment group was given Qi-tonifying and blood-activating therapy combined with biofeedback therapy,the treatment covering 20 d.Before and after treatment,the scores of symptoms,patient-reported outcomes(PRO),Self-rating Anxiety Scale(SAS),Selfrating Depression Scale(SDS)and Patient Assessment of Constipation Quality of Life(PAC-QOL)as well as the parameters of anorectal manometry and pelvic floor electrophysiological measurement in the two groups were detected.And after treatment,the therapeutic effect of the two groups was evaluated.Results(1)After treatment for 20 d,the total effective rate of the treatment group(85.00%)was higher than that of the control group(52.38%),and the difference was statistically significant(P<0.05).(2)Compared with those before treatment,the scores of symptoms,PRO,SAS,SDS and PAC-QOL as well as the parameters of anorectal manometry and pelvic floor electrophysiological measurement in the two groups were improved after treatment(P<0.05 or P<0.01),and the improvement in the treatment group was superior to that in the control group,the difference being statistically significant(P<0.05 or P<0.01).Conclusion Biofeedback therapy has a good effect on FDD-IDP,and its combination with Qi-tonifying and blood-activating therapy can enhance the therapeutic effect.
引文
[1] Chiarioni G,Salandini L,Whitehead W E. Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation[J]. Gastroenterology, 2005, 129(7):86.
[2]苏丹,任东林,林宏城.功能性排便障碍的肛肠动力学研究[J].胃肠病学和肝病学杂志,2010,19(3):265.
[3]朱芬芬,林征,林琳.功能性便秘患者生活质量的研究[J].中华消化杂志,2007,27(5):356.
[4] Patcharatrakul T,Valestin J,Schmeltz A,et al. Factors associated with response to biofeedback therapy for dyssynergic defecation[J].Clin Gastroenterol Hepatol,2018,16(5):715.
[5]喻玲.调和肝脾法治疗功能性便秘[J].现代诊断与治疗,2007,18(5):282.
[6]金洵.慢性便秘患者报告临床结局(PRO)评估量表的研制和考评[D].南京:南京中医药大学,2010.
[7] Zung W W. The measurement of affects:depression and anxiety[J]. Mod Probl Pharmacopsychiatry,1974,7(7):170.
[8] Marquis P, De La Loge C, Dubois D, et al. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire[J]. Scand J Gastroenterol,2005,40(5):540.
[9]金锋,陈富军.补中益气汤加减治疗老年功能性便秘116例[J].陕西中医,2009,30(1):38.
[10]马相斌.益气活血法治疗功能性便秘[J].光明中医,2009,24(9):1701.
[11]赖象权,朱东东,王子明.益气活血化瘀汤治疗老年功能性便秘的临床研究[J].时珍国医国药,2011,22(12):3035.
[12]丁曙晴,丁义江.盆底表面肌电生物反馈在功能性排便障碍诊治中的应用[J].中华物理医学与康复杂志,2009,31(5):349.
[13] Palsson O S, Heymen S, Whitehead W E. Biofeedback treatment for functional anorectal disorders:a comprehensive efficacy review[J]. Appl Psychophysiol Biofeedback,2004,29(3):153.
[2]苏丹,任东林,林宏城.功能性排便障碍的肛肠动力学研究[J].胃肠病学和肝病学杂志,2010,19(3):265.
[3]朱芬芬,林征,林琳.功能性便秘患者生活质量的研究[J].中华消化杂志,2007,27(5):356.
[4] Patcharatrakul T,Valestin J,Schmeltz A,et al. Factors associated with response to biofeedback therapy for dyssynergic defecation[J].Clin Gastroenterol Hepatol,2018,16(5):715.
[5]喻玲.调和肝脾法治疗功能性便秘[J].现代诊断与治疗,2007,18(5):282.
[6]金洵.慢性便秘患者报告临床结局(PRO)评估量表的研制和考评[D].南京:南京中医药大学,2010.
[7] Zung W W. The measurement of affects:depression and anxiety[J]. Mod Probl Pharmacopsychiatry,1974,7(7):170.
[8] Marquis P, De La Loge C, Dubois D, et al. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire[J]. Scand J Gastroenterol,2005,40(5):540.
[9]金锋,陈富军.补中益气汤加减治疗老年功能性便秘116例[J].陕西中医,2009,30(1):38.
[10]马相斌.益气活血法治疗功能性便秘[J].光明中医,2009,24(9):1701.
[11]赖象权,朱东东,王子明.益气活血化瘀汤治疗老年功能性便秘的临床研究[J].时珍国医国药,2011,22(12):3035.
[12]丁曙晴,丁义江.盆底表面肌电生物反馈在功能性排便障碍诊治中的应用[J].中华物理医学与康复杂志,2009,31(5):349.
[13] Palsson O S, Heymen S, Whitehead W E. Biofeedback treatment for functional anorectal disorders:a comprehensive efficacy review[J]. Appl Psychophysiol Biofeedback,2004,29(3):153.