功能性便秘患者社会、心理、行为状况调查及生物反馈治疗效果随访  

Social, psychosocial and behavior characteristics of patients with functional constipation and the follow-up of the effects of biofeedback therapy

作　　者：林征[1] 林琳[1] 张红杰[1] 王美峰[1] 

机构地区：[1]南京医科大学第一附属医院消化科,江苏省南京市210029

出　　处：《中国临床康复》2005年第28期67-69,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:评估功能性便秘患者心理状况、遭遇生活事件情况、观察生物反馈疗效的随访结果,了解与便秘发生有关的因素、便秘对患者生活的影响及患者对便秘的信心。方法:①选择1998-01/2001-12在南京医科大学第一附属医院消化科胃肠动力中心接受生物反馈治疗的功能性便秘患者44例为治疗组。男16例,女28例。均自愿参加。排除不能接受电话和信件随访者。2000-12/2001-04选择古平岗社区健康自愿者31人为对照组,男12人,女19人。②采用美OrionPC/4EMG肌电生物反馈训练治疗系统,患者每周到本院胃肠动力中心训练3次,50～60min/次,1个疗程10～15次,同时每天在家中进行同步练习,练习时间和次数因人而异。③纳入对象心理社会状况和遭遇生活事件的评估采用症状自评量表(包括90多项内容,并分为躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执和精神病性等9大症状因子。分别记1～4分,1为无,4为严重。其主要评分指标为总分、总均分、阳性项目数、阴性项目数、阳性症状均分)、医院焦虑抑郁量表(主要用于医院内科门诊或住院评定患者的焦虑和抑郁状态,由14个条目组成,其中7个条目评定焦虑,7个条目评定抑郁,每一条目以0～3四级记分)和生活事件量表(共65个项目,包括职业、学习、婚姻和恋爱、家庭和子女、经济、司法、人际关系等方面常见的生活事件)。以上量表均在治疗开始前完成。④社会、心理、行为因素及生物反馈疗效随访采用自拟患者情况调查表问卷调查法。生物反馈治疗前的内容为患者的一般情况、既往和目前排便情况、病程、既往检查治疗情况,平素饮食活动情况,便秘对其生活质量的影响;远期随访的内容包括进行生物反馈治疗前后症状改善情况、自己对疗效的评价,以及对便秘的认识、对治疗的信心和希望等。采用电话调查、信函调查�AIM： To evaluate the psychosocial characteristics, life events, and the outcome of biofeedback in patients with functional constipation, and investigate the correlative factors of functional constipation, and the effects of constipation on quality of life and the confidence of the patients.METHODS： ①Forty-four（male 16 and female 28） patients with functional constipation were selected as the functional constipation group, who were treated in the Center for Gastrointestinal Motility of the First Affiliated Hospital of Nanjing Medical University during January 1998 and December 2001. Thirty-one （male 12 and female 19） healthy volunteers from the Gupinggang community were taken as the controls between December 200 and April 2001. All the subjects were attend our investigation voluntarily.②The patients were treated with Orion PC/4 EMG Biofeedback Training System for 3 times, 50 to 60 minutes once for a total 10 to 15 courses at our Gastrointestinal Motility Center, and they were also trained at home.The time for training and times of training was different in different people.③Symptom checklist 90 （SCL-90, the test is scored for 90 symptoms,including nine clinical subscales as follows： somatization of affection,obsessive-compulsive symptoms, interpersonal sensitivity, depression,anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism）, the Hospital Anxiety and Depression （HAD, used to assess the anxiety and depress status of the outpatients and inpatients, including fourteen items,scored from 1 to 4）, and the Life Event Scale were completed by these 44 patients and 31 healthy subjects to access their psychosocial characteristics. All tests were scored before the treatment. ④All patients were also asked to make a global assessment. Before treatment, assessment included the history, the bowel habit, diet and the influence on the life.After treatment and at one year after follow-up, the investigation included the treatment effect by stating whether their bowel problems were w

关 键 词：功能性便秘 生物反馈 社会心理行为因素 疗效 

分 类 号：R749[医药卫生—神经病学与精神病学]