基于析因设计观察针刺及生物反馈治疗功能性肛门直肠痛的临床疗效  

Efficacy of Acupuncture and Biofeedback on Functional Anorectal Pain Based on Factorial Design

作　　者：罗宏标[1,2] 廖莎 唐清珠[1] 陈鸣旺[1] 张盛甫[1] 罗育连[1] LUO Hongbiao;LIAO Sha;TANG Qingzhu;CHEN Mingwang;ZHANG Shengfu;LUO Yulian(Chenzhou First People's Hospital,Chenzhou Hunan 423000,China;Graduate School,Hunan University of Chinese Medicine,Changsha Hunan 410208,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

出　　处：《中医药导报》2022年第9期62-65,70,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

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);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:观察针刺及生物反馈治疗功能性肛门直肠痛的临床疗效。方法:选取48例功能性肛门直肠痛患者为研究对象,按随机数字表法随机分为A组、B组、C组、D组,每组12例。A组患者予常规治疗,B组患者予常规治疗+生物反馈治疗,C组患者予常规治疗+针刺治疗,D组患者予常规治疗+生物反馈治疗+针刺治疗。基于析因设计比较4组患者视觉模拟评分(VAS评分)、生存质量及肛管直肠动力学。结果:通过析因设计分析治疗后各组VAS评分情况,在α=0.05水准上,模型Corrected Model检验F=6.81,P=0.00<0.05,模型有统计学意义。在针刺与生物反馈的交互作用统计分析结果中,F=3.26,P=0.08,P>0.05,提示针刺、生物反馈之间的交互作用无统计学意义。同时在分析生物反馈的单独效应结果中显示,F=10.21,P=0.00<0.05,差异有统计学意义,而且就针刺的单独效应结果来看,F=6.97,P=0.01<0.05,可见生物反馈和针刺均对肛门直肠痛有改善效果。4组患者治疗后PAC-QOL评分均低于同组治疗前(P<0.01);治疗后PAC-QOL评分A组最高、B组及C组居中、D组最低,B组与C组比较,差异无统计学意义(P>0.05),A组与D组比较,差异有统计学意义(P<0.01),A组、D组分别与B组及C组比较,差异均有统计学意义(P<0.01)。4组治疗后肛管静息压、肛管最大收缩压、肛管高压区长度均低于治疗前(P<0.01);治疗后4组患者肛管直肠动力学变化中D组最高、B组及C组居中、A组最低,B组与C组比较,差异无统计学意义(P>0.05),A组与D组比较,差异有统计学意义(P<0.01),A组、D组分别与B组及C组比较,差异均有统计学意义(P<0.01)。结论:针刺、生物反馈可改善功能性肛门直肠痛患者的疼痛,且针刺、生物反馈联合使用可有效提高患者生存质量,其机制可能与改善患者肛管直肠动力学相关。Objective:To observe the clinical effect of acupuncture and biofeedback on functional anorectal pain.Methods:A total of 48 patients with functional anorectal pain were selected as the research objects and they were randomly divided into group A,group B,group C and group D according to the random number table method,with 12 cases in each group.Patients were treated with conventional treatment in Group A,conventional treatment+biofeedback in Group B,conventional treatment+acupuncture in Group C and conventional treatment+biofeedback+acupuncture in Group D.The visual analogue scale(VAS score),life quality and anorectal dynamics were compared among the four groups based on a factorial design.Results:The VAS scores of each group were analyzed by factorial design.At the level ofα=0.05,in the Corrected Model test,F=6.81,P=0.00<0.05,the model was statistically significant.In the statistical analysis results of the interaction between acupuncture and biofeedback,F=3.26,P=0.08>0.05,it indicaed that the interaction between acupuncture and biofeedback was not statistically significant. At the same time, in the analysis of the individual effect results of biofeedback, F=10.21, P=0.00<0.05, the difference was statistically significant. And in terms of the individual effect results of acupuncture, F=6.97, P=0.01<0.05, the difference was also statistically significant. It indicates that both biofeedback and acupuncture can improve the pain relief effect on anorectal pain. After treatment, patients in four groups showed lower PAC-QOL scores than before treatment (P<0.01). After treatment, Group A showed the highest PAC-QOL score and group D showed the lowest PAC-QOL score, with group B and group C in the middle. There was no significant difference in PAC-QOL score between group B and group C (P>0.05). There was significant difference in PAC-QOL score between group A and group D (P>0.05). The PAC-QOL score comparison between group A and group C, comparison between group A and group D, comparison between group B and group C, and c

关 键 词：功能性肛门直肠痛 针刺 生物反馈 八髎穴 临床研究 

分 类 号：R246.2[医药卫生—针灸推拿学]