生物反馈电刺激联合盐酸伊托必利治疗慢性功能性出口梗阻型便秘的疗效及对患者肛门直肠动力学的影响  

Clinical efficacy and impact on anorectal manometry of biofeedback electrical stimulation combined with itopride hydrochloride in patients with chronic functional outlet obstruction constipation

作　　者：陈建兴 郑媛媛[1] 庄云英[1] 陈玲红[1] 吴美玉 黄永德[1] 陈旭东[1] 吴美娟 Chen Jianxing;Zheng Yuanyuan;Zhuang Yunying;Chen Linghong;Wu Meiyu;Huang Yongde;Chen Xudong;Wu Meijuan(Department of Gastroenterology,The 910th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army/Affiliated Haixia Hospital of Huaqiao University,Quanzhou Fujian 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院/华侨大学附属海峡医院消化内科,福建泉州362000

出　　处：《保健医学研究与实践》2024年第7期57-62,共6页Health Medicine Research and Practice

基　　金：福建省自然科学基金项目(2022J01311)。

摘　　要：目的探讨生物反馈电刺激联合盐酸伊托必利治疗慢性功能性出口梗阻型便秘的临床疗效及对患者肛门直肠动力学的影响,以期为该类患者的临床治疗提供参考。方法采用随机数字表法将2022年1月—2024年3月中国人民解放军联勤保障部队第910医院诊治的110例慢性功能性出口梗阻型便秘患者分为观察组和对照组,每组55例。对照组患者采用盐酸伊托必利治疗,观察组患者采用生物反馈电刺激联合盐酸伊托必利治疗。治疗1个月后,比较2组患者的临床疗效及治疗期间的不良反应发生情况,同时比较2组患者治疗前后的肛门直肠动力学指标、直肠感觉功能指标及氧化应激水平。结果观察组患者的治疗总有效率为98.18%(54/55),高于对照组的85.45%(47/55),差异有统计学意义(χ^(2)=4.356,P=0.037)。2组患者治疗期间不良反应发生率比较,差异无统计学意义(χ^(2)=0.484,P=0.487)。治疗前,2组患者的肛管静息压、肛管最大收缩压、肛管最大缩榨压水平比较,差异均无统计学意义(P>0.05);治疗1个月时,2组患者的肛管静息压、肛管最大收缩压、最大缩榨压水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者的最大耐受容量、初次排便感觉阈值、排便窘迫感阈值水平比较,差异均无统计学意义(P>0.05);治疗1个月时,2组患者的最大耐受容量、初次排便感觉阈值、排便窘迫感阈值水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者的血清超氧化物歧化酶(SOD)、丙二醛(MDA)及过氧化脂质(LPO)水平比较,差异均无统计学意义(P>0.05);治疗1个月时,2组患者的血清SOD水平均高于治疗前且观察组高于对照组,血清MDA、LPO水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论生物反馈电刺激联合盐酸伊托必利治疗能够有效缓Objective To explore the clinical efficacy and impact on anorectal manometry of biofeedback electrical stimulation combined with itopride hydrochloride in patients with chronic functional outlet obstruction constipation(CFOOC),aiming to provide a reference for the clinical treatment of such patients.Methods From January 2022 to March 2024,110 patients with CFOOC treated at our hospital were randomly divided into an observation group and a control group,each consisting of 55 cases,using the random number table method.The control group was treated with itopride hydrochloride,while the observation group was treated with a combination of biofeedback electrical stimulation and itopride hydrochloride.The clinical efficacy and adverse reaction occurrence during the treatment period were compared between the two groups after one month of treatment.The anorectal manometry indices,rectal sensory function indices,and oxidative stress levels before and after treatment were also compared.Results The overall response rate of treatment in the observation group was significantly higher than that in the control group[98.18%(54/55)vs.85.45%(47/55);χ^(2)=4.356,P=0.037].No statistically significant difference was noted in the incidence of adverse reactions during the treatment period between the two groups(χ^(2)=0.484,P=0.487).Before treatment,there were no statistically significant differences in anal canal resting pressure,anal canal maximum contraction pressure,and anal canal maximum squeeze pressure levels between the two groups(P>0.05);after one month of treatment,these levels were lower than before treatment in both groups,and the observation group had lower levels than the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in maximum tolerable volume,initial defecation sensation threshold,and defecation urgency threshold levels between the two groups(P>0.05);after one month of treatment,these levels were lower than before treatment in both gr

关 键 词：生物反馈电刺激 盐酸伊托必利 慢性功能性出口梗阻型便秘 临床疗效 肛门直肠动力学 直肠感觉功能 氧化应激 

分 类 号：R574.62[医药卫生—消化系统]