生物反馈训练对不同亚型功能性排便障碍患者临床症状、心理状况和生命质量的影响  

Effects of biofeedback training on clinical symptoms,psychological status and quality of life in different subtypes of patients with functional defecation disorders

作　　者：张星[1] 林征[2] 王美峰[3] 林琳[3] 张红杰[3] 

机构地区：[1]南京医科大学护理学院,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》2015年第9期606-610,共5页Chinese Journal of Digestion

摘　　要：目的比较生物反馈训练对不同亚型功能性排便障碍（FDD）患者临床症状、心理状况和生命质量的影响。方法依据罗马Ⅲ诊断标准将50例 FDD 患者分为不协调性排便（F3a）和排便推进力不足（F3b）两个亚型。两个亚型患者每周至胃肠动力中心进行生物反馈训练3次，每个疗程5-10次，治疗期间及治疗后均要求每天2-3次家庭训练。比较两个亚型患者生物反馈训练前后临床症状、焦虑自评量表（SAS）和抑郁自评量表（SDS）得分、中文版患者便秘状况评估问卷（PAC‐QOL）得分变化及两个亚型之间的差异。同组治疗前后比较采用配对 t检验或 Wilcoxon 符号秩检验，组间比较采用成组t检验或 Wilcoxon 秩和检验。结果50例 FDD 患者中，F3a 型13例，F3b 型37例。 F3a 型和 F3b 型患者训练后症状积分均低于训练前（5．62±3．91比8．77±3．59，5．89±3．67比9．35±3．22；t ＝3．264、6．272，P均＜0．01），而训练前与训练后两型之间症状积分比较，差异均无统计学意义（t ＝－0．545、－0．230，P均＞0．05）。 F3a 型和 F3b 型患者训练后 SAS 得分低于训练前（30．85±6．67比42．46±8．37，30．65±7．51比38．59±8．38；t ＝4．536、6．402，P均＜0．01），SDS 得分均低于训练前（42．85±8．30比53．92±7．98，43．95±12．17比55．39±10．83；t＝4．788、6．830，P 均＜0．01），训练前后两型之间 SAS 、SDS 得分比较，差异均无统计学意义（tSAS ＝1．431、0．084，tSDS ＝－0．447、－0．301，P均＞0．05）。 F3a 型和F3b 型患者训练后 PAC‐QOL 得分[0．54（0．15，0．88）、0．98（0．51，1．34）]均低于训练前[2．08（1．18，2．34）、1．86（1．34，2．29）]，Z＝－2．903、－4．825。 P均＜0．01]，训练前后两型之间得分比较，差异均无统计学意义（Z＝0．409、1．891，P均＞0．05）。结论生物反馈训练对 FDD 两个亚型均Objective To compare the effects of biofeedback （BF） training on clinical symptoms , psychological status and quality of life in different subtypes of patients with functional defecation disorders （FDD） .Methods According to Rome Ⅲ criteria ,50 FDD patients were divided into non coordinated defecation （F3a） and the lack of promoting defecation （F3b） two subtypes .The patients of these two subtypes received BF training three times every week ,five to ten times each course ,two to three times training at home were required during and after treatment .The changes ,of clinical symptoms scores ,self‐rating anxiety scale （SAS） ,self‐rating depressive scale （SDS） and the patient assessment of constipation quality of life question naire （PAC‐QOL ） were compared between before and after BF training in the patients of two subtypes .The difference between two subtypes were also analyzed as well .Paired t‐test or Wilcoxon signed‐rank test was performed for comparison between before and after treatment ,and group t‐test or Wilcoxon rank sum test was for comparison between groups .Results Among 50 FDD patients , there were 13 cases of F3a type and 37 cases of F3b type .After BF training ,the clinical symptoms scores of two subtypes patients were both lower than those before BF training （5 .62 ± 3 .91 vs 8 .77 ± 3 .59 , 5 .89 ± 3 .67 vs 9 .35 ± 3 .22 ,t = 3 .264 and 6 .272 ,both P〈 0 .01） .There were no statistically significant differences in the scores of clinical symptoms between two subtypes at before and after BF training （t =- 0 .545 and - 0 .230 ,both P 〉 0 .05） .After BF training ,the SAS scores of two subtypes patients were both lower than those before BF training （30 .85 ± 6 .67 vs 42 .46 ± 8 .37 ,30 .65 ± 7 .51 vs 38 .59 ± 8 .38 , t= 4 .536 and 6 .402 ,both P〈 0 .01） ,and the scores of SDS were both lower than those before BF training （42 .85 ± 8 .30 vs 53 .92 ± 7 .98 ,43 .95 ± 12 .17 vs 55 .39 ± 10 .83 ,t = 4 .788 and 6 .830 ,both P〈 0 .01�

关 键 词：功能性排便障碍 生物反馈 临床症状 心理状况 生命质量 

分 类 号：R574.62[医药卫生—消化系统]