生物反馈治疗对慢传输型便秘患者肠功能调节作用的研究

Biofeedback therapy on enteric modulation in patients with chronic constipation

目的探讨生物反馈治疗慢传输型便秘的前景及机制。方法使用Medtronic Synectics公司的SYS Orin PC-12和U-Control TMEMG Home Trainer生物反馈训练系统为患者进行治疗,使患者学会识别自身正常和异常的电信号,教会患者进行正确的排便,并对治疗前后患者的症状变化及肛管静息压、最大收缩压、直肠容量感觉阈值、直肠肛门抑制性反射等进行自身对照研究。结果慢传输型便秘生物反馈治疗后可使肛管平均静息压增大,最大收缩压减少,直肠容量感觉阈值减少,直肠肛门抑制性反射减少,肛管向量容积舒张期减少,收缩期增加。结论生物反馈疗法可以明显改善便秘患者的排便困难、粪便太硬、便意减少等症状,并使患者学会正确的排便动作,为生物反馈治疗便秘的临床应用提供了依据。

Objective To explore the prospect and mechanism of biofeedback therapy.Methods Biofeedback therapy was conducted using SYS Orin PC-12 and U-Control TMEMG Home Trainer systems（Medtronic Synectics Co.Ltd.）.Patients were trained as on how to identify normal or abnormal electrical signals and defecate properly.A self-contrast study was performed on the variation in symptoms,anal canal resting pressure,maximal contracting pressure,rectal volume-sensing threshold and anorectal inhibitory reflex.Results Increased mean anal canal resting pressure as well as reduced maximal contracting pressure,rectal volume-sensing threshold and anorectal inhibitory reflex were recorded in patients with chronic slow-transmission constipation treated by biofeedback system.Also the detection were shortened dilation phase and prolonged contracting period as revealed by vector analysis of anal canal.Conclusion Biofeedback system can markedly ameliorate difficulty in defecation,reduce solidity of feces,improve the desire to defecate and guide patients defecate properly,thus offering proofs for the clinical application in the treatment of constipation.