慢性便秘患者生物反馈疗法的疗效预测因素分析  

Predictors of efficacy of biofeedback therapy in patients with chronic constipation

作　　者：李苗苗[1] 叶必星[1] 汤玉蓉[1] 王美峰[1] 田园[2] 张红杰[1] 李学良[1] 林琳[1] 

机构地区：[1]南京医科大学第一附属医院消化科,210029 [2]南京医科大学护理学院

出　　处：《中华内科杂志》2014年第1期40-43,共4页Chinese Journal of Internal Medicine

摘　　要：目的 探讨慢性便秘（CC）患者生物反馈（BF）疗法的疗效预测因素.方法 对70例CC患者进行BF治疗,治疗前应用焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活质量汉化版简明健康调查量表（SF-36）及生活方式量表进行问卷调查,同时对患者进行肛门直肠测压.治疗前后通过症状积分量表评定患者5项主要症状,以治疗前后症状积分变化作为BF疗效判断指标,对治疗前采集的可能影响BF疗效的因素进行单因素、多因素分析,得出BF疗效的独立预测因素.结果 单因素分析结果显示,BF疗效与生活质量中的“生理职能”维度呈正相关（r=0.256,P=0.031）,与SDS评分（r=-0.315,P=0.007）、初始感觉阈值（r＝-0.278,P=0.020）呈负相关.多因素分析结果显示,SDS评分（β=-0.263,P=0.033）、初始感觉阈值（β=-0.281,P=0.013）是BF疗效的独立预测因素.结论 存在抑郁倾向、直肠低敏感的CC患者BF疗效较差,采用相应的治疗措施有助于优化BF疗效.Objective To explore the anorectal physiology,psychological state,quality of life,lifestyle of patients with chronic constipation （CC） and evaluate the factors which potentially predict the efficacy of biofeedback therapy（BF）.Methods Seventy CC patients receiving BF training were enrolled in this study.Anorectal physiology,Zung＇s Self-Rating Depression Scale （SDS）,Zung＇s Self-Rating Anxiety Scale （SAS） and Chinese version of the MOS 36-item short form healthy survey（SF-36）,lifestyle scale were recorded before BF training.A bowel symptom measurement including five major symptoms was recorded before and after BF training.The improvement in the symptom score was considered as criteria of clinical efficacy of BF therapy.Thirty-two possible influencing factors of efficacy of BF therapy were selected.Univariate analysis and multivariate analysis were conducted to assess the independent predictors.Results The results of univariate analysis showed that efficacy of BF therapy was positively correlated to the role physical （r =0.256,P =0.031）,negatively correlated to the score of SDS （r =-0.315,P =0.007） and the first sensation threshold （r =-0.278,P =0.020）.The multivariate analysis showed the score of SDS （β =-0.263,P =0.033） and the first sensation volume （β =-0.281,P =0.013） were the independent predicators of efficacy of BF therapy.Conclusion CC patients who tended to depression state and rectal hyposensitivity have poor response to BF therapy.To treat these patients purposely could optimize the efficacy of BF therapy.

关 键 词：便秘 生物反馈 心理学 治疗结果 预测 

分 类 号：R574.62[医药卫生—消化系统]