非植入性骶神经刺激和电针八髎穴治疗慢性便秘的效果比较  

Comparison of non-implantable sacral nerve stimulation with electro-acupuncture at Baliao acupoint for chronic constipation

作　　者：张波 沈云天 黄艳 李向武 陈巧玲 任佳慧 郑建勇 Zhang Bo;Shen Yuntian;Huang Yan;Li Xiangwu;Chen Qiaoling;Ren Jiahui;Zheng Jianyong(Division IV of Anorectal Surgery, The Mayinglong Coloproctological Hospital of Xi’an, Xi’an 710005, Shaanxi, China;Department of Digestive Surgery, Xijing Hospital, Air Force Medical University, Xi’an 710032, Shaanxi, China)

机构地区：[1]西安马应龙肛肠医院肛肠四科,陕西西安710005 [2]空军军医大学西京医院消化外科,陕西西安710032 [3]第二军医大学东方肝胆外科医院 [4]美国明尼苏达大学 [5]中国医师协会结直肠肿瘤专委会中西医结合诊疗专委会、肛肠医师分会、外科医师分会肛肠外科医师委员会

出　　处：《结直肠肛门外科》2019年第5期506-512,共7页Journal of Colorectal & Anal Surgery

基　　金：国家自然科学基金面上项目（81470816）

摘　　要：目的评价非植入性骶神经刺激治疗和电针八髎穴治疗慢性便秘的临床效果。方法选择2016年9月至2017年11月在西安马应龙肛肠医院肛四科住院接受电刺激治疗的86例慢性便秘患者为研究对象,随机将患者分为两组,治疗组为非植入SNS组(n=42),对照组为电针八髎穴组(n=44)。对比两组治疗前后组间、组内的便秘症状评分、慢传输试验结果和肛门直肠压力情况。结果与治疗前相比,治疗后两组便秘症状评分下降,慢传输试验阳性的总残留及乙直肠残留减少,直肠排便压、排便压力梯度升高,治疗组慢传输试验阳性的升结肠及横结肠残留减少、直肠静息压升高,对照组慢传输试验阳性的降结肠残留减少,差异均有统计学意义(均P<0.05)。治疗前,两组各评价指标比较,差异均无统计学意义(均P>0.05)。治疗后,治疗组便秘症状评分低于对照组,直肠排便压、排便压力梯度高于对照组,差异均有统计学意义(均P<0.05)。结论SNS与电针八髎穴均可作为慢性便秘的可选治疗方法,均可获得较为理想的短期疗效,SNS总体治疗效果更优。Objectives To evaluate the effect of non-implantable sacral nerve stimulation and electro-acupuncture at Baliao acu point for treating chronic constipation. Methods Eighty-six patients with chronic constipation who received electrical stimulation at Division IV of Anorectal Surgery, The Mayinglong Coloproctological Hospital of Xi’an, between September 2016 and November 2017 were recruited and randomly assigned to two groups. The treatment group received non-implantable sacral nerve stimulation (n = 42), and the control group received electro-acupuncture at Baliao acupoint (n = 44). Constipation symptoms score, slow tran sit constipation test results, anal and rectal pressure were compared before and after surgery within each group as well as be tween the groups. Results In both groups, the constipation symptoms score decreased significantly after the treatment, the total residual and the sigmoid colon-rectum residual decreased significantly in the rate of positive residual from slow transit test, and the rectal pressure (simulated defecation) and its gradient increased significantly after the treatment ( P < 0.05). In the treatment group, the rate of positive residual at ascending colon and transverse colon derecresed significantly, and the rectal resting pres sure increased significantly after treatment ( P < 0.05). In the control group, the rate of positive residual at the descending colon decreased significantly ( P < 0.05). All indices did not differ significantly between the two groups before the treatment ( P > 0.05). The constipation symptoms score in the control group was significantly higher than in the treatment group after the treat ment, while the rectal pressure (simulated defecation) and its gradient was contrary. Conclusion Both the nonimplantable sacral nerve stimulation and the electro-acupuncture at Baliao accupoint were effective treatment for chronic constipation with good short-term effect. The former had much better overall effectiveness.

关 键 词：慢性便秘 非植入性骶神经刺激 电针八髎穴 

分 类 号：R574.6[医药卫生—消化系统]