功能性肛门直肠痛临床特征分析

Clinical characteristics of functional anorectal pain： A report of 46 cases

目的 探讨功能性肛门直肠痛（functional anorectal pain,FARP）临床特征,指导临床诊疗.方法 在罗马Ⅲ诊断标准下回顾性分析46例功能性肛门直肠痛患者的临床资料.结果 46例FARP患者,男女之比1∶ 1.3;平均发病年龄51.43岁;主要表现为坠胀疼痛（56.5%）;15例（32.6%）患者有耻直肌牵拉痛;疼痛视觉模拟评分（VAS）平均为6.52;20例（43.5%）患者伴有其他盆底功能疾病;11例（23.9%）患者接受心理治疗;临床诊断肛提肌综合征15例（32.6%）,非特异性肛门直肠痛18例（39.1%）,痉挛性肛门痛13例（28.3%）;治疗上采用生物反馈结合针刺的方法,总有效率73.9%. 结论 FARP以慢性肛门痛多见,常伴有其他盆底功能障碍疾病和心理问题。

Objective To discuss the clinical characteristics of functiaonal anorectal pain （FARP） and guide the clinical diagnosis and therapy. Methods Clinical data of 46 patients with FARP were retrospectively reviewed according to the diagnostic criteria of Rome m. Results Of these 46 patients,the ratio of male to female was 1 ： 1.3 and the average age was 51.43 years. The patients mainly presented with heavy feeling and pain in the anus （56.5 % ）. Fifteen cases （32.6%）had tenderness during posterior traction on the puborectalis. The average of VAS score was 6.52. Twenty patients（43.5% ） were accompanied with other pelvic floor disorders. Eleven patients （ 23.9% ） received psychotherapy. There were levator syndrome in 15 cases（ 32.6% ）, unspecified functional anorectal pain in 18 cases （39.1%） and proctalgia fugax in 13 cases（28.3% ）. All these patients were treated by biofeedback combined with acupuncture and the total effective rate was 73.9%. Conclusion FARP is characterized by chronic anal pain. The patients are often accompanied with other pelvic floor diseases and psychological problems. Biofeedback and acupuncture are effective in the treatment of FARP. words ]