生物反馈疗法对不同亚型功能性排便障碍的疗效随访研究  

The follow-up study of the curative effect of biofeedback training on different subtypes of functional defecation disorders

作　　者：张星[1] 林征[2] 王美峰[3] 林琳[3] 

机构地区：[1]泰州职业技术学院医学技术学院,泰州225300 [2]南京医科大学护理学院 [3]南京医科大学第一附属医院消化科

出　　处：《南通大学学报（医学版）》2016年第4期270-273,共4页Journal of Nantong University(Medical sciences)

基　　金：江苏省教育厅2014年度高级访问工程师研训项目(2014FG094)

摘　　要：目的：综合评价生物反馈（biofeedback,BF）疗法对不同亚型功能性排便障碍（functional defecation disorders,FDD）的疗效,并分析BF治疗不同亚型FDD的效果动态变化趋势。方法：依据罗马Ⅲ诊断标准将46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BF治疗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BF前、BF后3个月、BF后6个月临床症状、焦虑自评量表和抑郁自评量表（Zung’s self-rating anxiety and depressive scale,SAS/SDS）得分、中文版患者便秘状况评估问卷（the patient assessment of constipation quality of life questionnaire,PAC-QOL）得分变化及两个亚型之间的差异。结果：共随访到42例FDD患者,F3a型14例,F3b型28例。重复测量资料的方差分析显示,临床症状、SAS/SDS、生活质量几个指标在亚型和时间两个因素均无交互作用（均P〉0.05）,主效应分析显示,上述指标在时间因素均有统计学意义（均P〈0.001）,亚型因素均无统计学意义（均P〉0.05）。对时间因素进行两两比较显示,两型临床症状积分、SAS/SDS得分、PACQOL得分在治疗后3、6个月与治疗前相比,得分均显著降低（均P〈0.001）,而治疗后3、6个月两个时间点比较则差异无统计学意义（均P〉0.05）。结论：BF治疗对FDD两个亚型均有效,治疗后3、6个月疗效稳定,两型疗效差异无统计学意义。Objective： To comprehensively evaluate the curative effect of biofeedback training on different subtypes of functional defecation disorders（ FDD）, and to analyze the trend of effective changes of the patients before and after the biofeedback training（BF）. Methods： 46 FDD patients were divided into two subtypes, non coordinated defecation（F3a） and the lack of promoting defecation（F3b）, according to Rome Ⅲ criteria. We conducted one session of 5 to 10 times BF treatment to all the subjects with 3 times per week. All the spatients were requiried to do 2 to 3 times training at home during and after treatment. The scores of clinical symptoms,Zung＇s self-rating anxiety scale（SAS） and Zung＇s depressive scale（SDS）, and the patient assessment of constipation quality of life questionnaire（PAC-QOL） were recorded to evaluate and compare the curative effect of biofeedback training on different subtypes of FDD among before BF treatment, 3 months after BF, and 6 months after BF. Results： 42 cases（14 F3 a and 28 F3b） of the 46 patients were succeeded to be followed up. Repeated ANOVA showed that the scores of clinical symptoms, SAS/SDS and PAC-QOL were not statisticaly different in time and subtyppe factors（all P〉0.05）.Analysis of the main effect showed that there were statistical diffferences in all the above scores between different time points（all P〈0.001）, while no differences in differnt subtypes（ P〉0.05）. Pairwise comparison showed that the scores of clinical symptoms, SAS/SDS and PAC-QOL 3 and 6 months after BF were statistically lower than the scores before BF（all P〉0.05）,while no difference between 3 and 6 months after BF（ P〉0.05）. Conclusions： BF training is effective on the two subtypes of FDD patients. The curative effect is stable in the two types FDD patients after treatment of 3 and 6 months. There is no difference of the effects between two subtypes.

关 键 词：功能性排便障碍 生物反馈 随访 

分 类 号：R442.2[医药卫生—诊断学]