电针联合生物反馈治疗盆底失弛缓型便秘患者疗效及对肛管直肠动力学的影响  

Efficacy of electroacupuncture combined with biofeedback on constipation of pelvic floor achalasia type and its effect on anorectal dynamics

作　　者：罗育连[1] 罗宏标[1,2] 唐清珠 陈鸣旺[1] 李国民[1] 彭昌能[3] LUO Yulian;LUO Hongbiao;TANG Qingzhu;CHEN Mingwang;LI Guomin;PENG Changneng(The First People’s Hospital of Chenzhou City, Chenzhou 423000, Hunan, China;Graduate School of Hunan University of Traditional Chinese Medicine, Changsha 410208, Hunan, China;the Fourth Hospital of Chenzhou City, Chenzhou 423000, Hunan, China)

机构地区：[1]郴州市第一人民医院,湖南郴州423000 [2]湖南中医药大学研究生院,湖南长沙410208 [3]郴州市第四人医院,湖南郴州423000

出　　处：《现代中西医结合杂志》2021年第28期3113-3117,3150,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：湖南省技术创新引导计划临床医疗技术创新引导项目(2017SK51109);湖南省郴州市科学技术局科技发展计划项目(zdyf201962);湖南省中医药科研计划课题青年项目(202103);湘南学院科学技术项目(2019-28)。

摘　　要：目的探讨电针联合生物反馈治疗盆底失弛缓型便秘患者疗效及对肛管直肠动力学的影响。方法选取2018年1月—2019年12月在郴州市第一人民医院肛肠外科治疗的盆底失弛缓型便秘患者80例,按随机数字表法随机分为常规治疗组、常规治疗+生物反馈组、常规治疗+针刺组、常规治疗+生物反馈+针刺组,每组20例。4组均给予相应治疗6周,比较4组患者便秘患者生存质量问卷(PAC-QOL)评分、肛管直肠动力学指标及临床疗效。结果4组治疗后PAC-QOL评分及肛管静息压、直肠静息压、肛管最大收缩压、肛管高压区长度、初始感觉阈值、最大容量感觉阈值均明显降低(P均<0.05),肛管随意弛缓反射值均明显升高(P均<0.05);常规治疗+生物反馈+针刺组各指标改善情况均明显优于其他组(P均<0.05),常规治疗+生物反馈组、常规治疗+针刺组明显优于常规治疗组(P均<0.05),常规治疗+生物反馈组与常规治疗+针刺组比较差异无统计学意义(P均>0.05);4组治疗后肛管直肠抑制反射值均无明显变化,组间及组内比较差异均无统计学意义(P均>0.05)。常规治疗+生物反馈+针刺组总有效率明显高于其他组(P均<0.05),常规治疗+生物反馈组、常规治疗+针刺组均明显高于常规治疗组(P均<0.05),常规治疗+生物反馈组与常规治疗+针刺组比较差异无统计学意义(P>0.05)。结论电针联合生物反馈治疗盆底失弛缓型便秘患者临床疗效显著,可有效提高患者生活质量,其机制可能与改善患者肛管直肠动力学相关。Objective It is to investigate the effect of electroacupuncture combined with biofeedback on constipation of pelvic floor achalasia type and its effect on anorectal dynamics.Methods A total of 80 patients with pelvic floor achalasia constipation who were treated in the Anorectal Surgery Department of the First People’s Hospital of Chenzhou from January 2018 to December 2019 were randomly divided into conventional treatment group,conventional treatment+biofeedback group,and conventional treatment+acupuncture group,conventional treatment+biofeedback+acupuncture group by random number table method,20 cases in each group.The four groups were treated with corresponding therapy for 6 weeks.The scores of the constipation quality of life questionnaire(PAC-QOL),anorectal dynamics indexes and clinical efficacy were compared among the four groups.Results After treatment,the PAC-QOL scores,resting pressure of anal canal,resting rectal pressure,maximum systolic pressure of anal canal,length of anal canal high pressure zone,initial sensory threshold,and maximum volume sensory threshold were significantly reduced(all P<0.05),the values of random relaxation reflex in the anal canal were significantly increased in the four groups(all P<0.05),the improvement of all indicators in the conventional treatment+biofeedback+acupuncture group was significantly better than that of the other groups(all P<0.05),the conventional treatment+biofeedback group,conventional treatment+acupuncture group were significantly better than the conventional treatment group(all P<0.05),and there was no statistically significant difference between the conventional treatment+biofeedback group and the conventional treatment+acupuncture group(all P>0.05);there was no significant change in the value of canal and rectal suppression reflex in the four groups after treatment,and there was no statistically significant difference among every group(all P>0.05).The total effective rate of the conventional treatment+biofeedback+acupuncture group was significantly high

关 键 词：电针疗法 生物反馈 盆底失弛缓型便秘 肛管直肠动力学 

分 类 号：R574.62[医药卫生—消化系统]