生物反馈训练治疗慢性功能性便秘的临床研究

Study on the Clinical Effect of Biofeedback Therapy for Functional Constipation

目的:随机对照研究、评估生物反馈训练治疗慢性功能性便秘的疗效。方法:60例慢性功能性便秘患者,随机分为治疗组30例和对照组30例。治疗组接受1个疗程(5周)生物反馈训练治疗(10次为一个疗程、一次30～45分钟、每周2次)。对照组患者接受聚乙二醇400010gBID口服,疗程5周。治疗前后作便秘症状评分、结肠通过试验检测、直肠肛门压力检测。结果:生物反馈训练和聚乙二醇4000均可使多数慢性功能性便秘患者的大便次数、大便性状及伴随症状恢复正常或缓解,总有效率分别为66.7%和80%(P>0.05)。生物反馈训练和聚乙二醇4000口服治疗后,结肠通过试验72小时标志物排出率分别为75%及73%,均较治疗前明显增加。生物反馈训练治疗后力排时肛门压明显下降。结论:生物反馈训练对出口梗阻型、慢传输型便秘均有效,是一种有效的、新兴的治疗慢性功能性便秘的方法,可作为功能性便秘的一线治疗方法。

Objective：To assess the clinic effect of biofeedback therapy for functional constipation.Methods：Sixty cases of chronic functional constipation were randomly divided into treatment group （30 cases） and control group （30 cases）.Cases in the treatment group were exposed to biofeedback for a five-week-long treatment course—individual treatment lasted for 30-45 minutes and twice per week.Patients in the control group received PEG 4000 10g BID for five weeks.Data from constipation symptom score,colonic transit test,and anorectal manometry were done and compared before and after two kinds of treatments.Results：Biofeedback training and PEG 4000 could restore the stoolfrequency,stool characteristics and accompanying symptoms to normal or mitigation of the majority of patients with chronic functional constipation,with the total effective rates being 66.7% and 80% （P〉0.05）,respectively.After biofeedback training and PGE 4000 treatment,the discharge rate of 72-hour markers of colonic transit test significantly increased to 75% and 73%,respectively.Additionally,anorectal pressure decreased dramatically after biofeedback training.Conclusion：Biofeedback training would play a positive role in outlet obstruction and slow transit constipation.Thus,it could be an effective first-line treatment of chronic functional constipation.