温阳益气方结合自我效能干预的生物反馈疗法对功能性排便障碍患者临床疗效及生活质量的影响  

Effects of biofeedback therapy combined with the Wenyang Yiqi Prescription and self-efficacy interventions on the clinical efficacy and quality of life in patients with functional defecation disorders

作　　者：吴本升[1] 孙明明[1] 徐治中[1] 潮露露 刘静[3] 程玮洁 王晓鹏[1] Wu Bensheng;Sun Mingming;Xu Zhizhong;Chao Lulu;Liu Jing;Cheng Weijie;Wang Xiaopeng(Department of Colorectal Surgery,Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China;Graduate School,Anhui University of Chinese Medicine,Hefei 230022,China;Department of Nursing,Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China;Treatment Center for Pelvic Floor Disease,Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China)

机构地区：[1]南京中医药大学附属苏州市中医医院肛肠科,苏州215009 [2]安徽中医药大学研究生院,合肥230022 [3]南京中医药大学附属苏州市中医医院护理部,苏州215009 [4]南京中医药大学附属苏州市中医医院肛肠盆底中心,苏州215009

出　　处：《国际中医中药杂志》2025年第1期36-43,共8页International Journal of Traditional Chinese Medicine

基　　金：苏州市重点病种诊疗技术项目(LCZX202114);国家自然科学基金(82104858);苏州市科技局项目(SKY2023214、SKY2023067);江苏省自然科学基金(BK20211085);苏州市姑苏卫生人才计划项目(GSWS2021046)。

摘　　要：目的探讨温阳益气方结合自我效能干预的生物反馈(BF)疗法对功能性排便障碍(FDD)患者的临床疗效及生活质量的影响。方法前瞻性随机对照试验设计。选择2021年1月-2023年4月南京中医药大学附属苏州市中医医院肛肠盆底中心128例FDD患者作为观察对象,采用随机数字表法分为2组,每组64例;另选择2015年6月-2018年1月南京中医药大学苏州附属医院肛肠科盆底中心接受BF训练治疗的41例FDD患者作为历史对照组。历史对照组予常规BF治疗,干预1组在历史对照组基础上联合自我效能干预治疗,干预2组在干预1组基础上加服温阳益气方。3组均干预2个疗程。分别于治疗前后进行便秘症状积分,采用健康行为自我效能评价量表(SRAHP)对自我效能进行评估,健康促进生活方式量表(HPLP)对健康行为进行评估,焦虑自评量表(SAS)及抑郁自评量表(SDS)评估焦虑、抑郁状态,简明健康调查量表(SF-36)评估患者生活质量,依据便秘症状积分结果评价临床疗效。结果治疗期间,因个人原因共计脱落7例,最终干预1组61例,干预2组60例进入疗效分析。干预1组总有效率为80.32%(49/61)、干预2组为83.33%(50/60)、历史对照组为56.10%(23/41),干预1组、干预2组总有效率高于历史对照组(χ^(2)值分别为7.06、9.15,P值分别为0.029、0.010)。治疗后,干预2组排便费力[1(1,2)分比2(1,2)分,Z=-4.51]积分低于干预1组(P<0.05),且干预2组排便费力[1(1,2)分比2(1,2)分,Z=-3.15]及排便时间[1(0,1)分比1(1,2)分,Z=-3.13]积分低于历史对照组(P<0.05);干预2组心理安适效能[(19.13±2.51)分比(16.98±1.86)分,t=5.36]、健康责任效能[(23.63±4.69)分比(22.59±3.05)分,t=2.06]评分及总分[(75.98±4.44)分比(72.33±5.16)分,t=4.17]高于干预1组(P<0.05),HPLP评分[(79.33±11.13)分比(72.80±9.20)分,t=3.10]高于历史对照组(P<0.05);干预2组情感职能评分[(75.98±18.45)分比(68.92±20.58)分、(68.55±18.21)分,F=20.91]高于干Objective To evaluate the clinical efficacy and impact on quality of life of the biofeedback(BF)therapy combined with the Wenyang Yiqi Prescription and self-efficacy interventions in patients with functional defecation disorders(FDD).Methods A prospective,randomized controlled trial design was employed.A total of 128 FDD patients were selected from the Pelvic Floor Center of the Department of Proctology,Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,between January 2021 and April 2023.These patients were randomly divided into two groups,with 64 cases in each group.Additionally,41 historical control patients,who had received conventional BF training between June 2015 and January 2018 at the same center,were included for comparison.The historical control group received conventional BF therapy,the intervention group 1 combined BF therapy with self-efficacy interventions,and the intervention group 2 added the Wenyang Yiqi Prescription based on intervention group 1's treatment.All three groups underwent two treatment courses.Constipation symptom scores before and after treatment were performed;self-efficacy was assessed via the Self-Rated Abilities for Health Practices scale(SRAHP);health behaviors were evaluated using the Health-Promoting Lifestyle Profile(HPLP);anxiety and depression were evaluated through Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS);quality of life was measured through SF-36.Clinical efficacy was evaluated based on constipation symptom scores.Results During the treatment period,seven patients dropped out due to personal reasons,leaving 61 patients in intervention group 1 and 60 patients in intervention group 2 for efficacy analysis.The total effective rates were 80.32%(49/61)in intervention group 1,83.33%(50/60)in intervention group 2,and 56.10%(23/41)in the historical control group.The total effective rates of both intervention groups were significantly higher than those in the historical control group(χ^(2)=7.06,9.15;P=0.0

关 键 词：排便异常 温阳益气方 自我效能干预 生物反馈 心理状况 生活质量 

分 类 号：R47[医药卫生—护理学]