生物反馈治疗功能性便秘的远期疗效及影响因素分析  

Long-term efficacy and the influencing factors analysis of biofeedback therapy in functional constipation

作　　者：宋玉磊[1] 林征[2] 林琳[3] 王美峰[3] 张红杰[3] 

机构地区：[1]南京中医药大学护理学院实验中心,210029 [2]南京医科大学第一附属医院护理部 [3]南京医科大学第一附属医院消化科

出　　处：《中华消化杂志》2013年第1期42-46,共5页Chinese Journal of Digestion

摘　　要：目的评价生物反馈（BF）治疗功能性便秘（FC）的远期疗效及影响因素。方法对109例接受BF治疗的FC患者进行回顾性随访，比较患者BF治疗前和随访时的临床症状积分、泻剂使用情况、结肠传输试验结果和肛门直肠测压结果，评价BF治疗的远期疗效。选择32项可能对BF治疗远期疗效产生影响的因素并进行单因素和多因素分析。组问比较采用t检验、秩和检验或Z。检验，远期疗效影响因素的判定采用多元逐步回归分析。结果FC患者随访时的中位症状总积分（3）显著低于BF治疗前（10，Z=-7．900，P〈0．01），远期总有效率为70．6％（77／109）。随访时泻剂使用率E39．4％（43／109）]低于治疗前E83．5％（91／109），X2=44．623，P〈0．01]。随访时的48h结肠排空率（30．0％）高于治疗前（0，Z=-2．298，P=0．022）。随访时存在不协调排便者的比例j51．4％）低于BF治疗前（77．1％，）X2=5．040，P=0．025）。单因素和多因素分析结果显示，BF治疗的远期疗效与家庭训练依从性和社会支持利用度正相关，与病程负相关。结论BF治疗能改善FC患者临床症状，纠正生理功能障碍，远期疗效满意。家庭训练依从性、社会支持利用度、病程是BF远期疗效的独立影响因素。Objective To evaluate the long-term efficacy and the influencing factors of biofeedback （BF） treatment in functional constipation （FC）. Methods Totally 120 BF treated FC patients were retrospectively followed up. The clinical symptom score, the use of laxatives, the result of colonic transit test and anorectal manometry were compared before BF treatment and during follow-up. The long-term efficacy of biofeedback treatment was evaluated. Thirty-two possible influencing factors of long-term efficacy were selected and univariate and multivariate analysis were conducted. The groups were compared with t test, rank-sum test and X2 test. The influencing factors of long-term efficacy were analyzed with a stepwise multiple regression analysis. Results The median score of clinical symptoms in follow-up period （3） was significantly lower than that before BF treatment （10, Z=-7. 900, P〈0.01）. The total long-term efficacy rate was 70.6% （77/109）. During follow-up, the rate of laxatives use [39.4% （43/109）] was lower than that before BF treatment [83. 5% （91/ 109）, X2=44. 623, P〈0. 01]. During follow-up, the 48 hour median colonic emptying rate （30.0%） was higher than that before BF treatment （0, Z=-2. 298, P=0. 022）. During follow-up, the proportion of patients with uncoordinated defecation （51. 4%） was lower than that before BF treatment （77. 1%, z = 5. 040, P = 0. 025）. The results of univariate and multivariate analysis showed that the long term efficacy of BF treatment was positively correlated with the compliance for home training and utilization of social support, negatively correlated with the course of disease. Conclusions BF therapy can improve clinical symptoms of FC patients, correct physiological dysfunction and have a satisfactory long-term efficacy. Compliance for home training, utilization of social support and the course of disease were independent influencing factors.

关 键 词：生物反馈(心理学) 便秘 随访研究 因素分析 统计学 

分 类 号：R574.62[医药卫生—消化系统]