自适应性生物反馈训练对出口梗阻型便秘患者临床疗效、心理状况和生命质量的影响

Impact of adaptive biofeedback training on clinical efficacy, psychological status and quality of life in patient with outlet obstruction constipation

目的探讨自适应性生物反馈训练（ABF）对出口梗阻型便秘（OOC）患者临床症状疗效、心理状况和生命质量的改善程度。方法纳入2011年6月至2014年10月就诊的OCC患者206例，分成ABF组和固定式生物反馈训练（FBF）组。观察治疗前和治疗后8周患者便秘临床症状、临床疗效、心理状态和生命质量情况。统计学分析采用卡方检验或t检验。结果共有138例完成了生物反馈治疗，其中ABF组76例，FBF组62例。ABF组和FBF组治疗前便秘临床症状总积分分别为10．95±2．86和¨．20±2．23，治疗后分别为2．02±1．10和2．98±I．19，两组治疗后症状总积分均下降（t=2．60、2．45，P均〈0．05）；ABF组治疗前后的总积分差值为8．93±0．37，高于FBF组的8．24±0．29，差异有统计学意义（t=2．53，P〈0．05）。ABF组总有效率为94．7％（72／76），高于FBF组的85．5％（53／62），差异有统计学意义（X^2=3．426，P〈0．05）。治疗后，ABF组焦虑自评量表（SAS）和抑郁自评量表（SDS）评分分别为37．7±9．1和41．4±7．4，低于治疗前的48．2±II．7和50．7±9．6，差异均有统计学意义（t=9．54、5．01，P均〈0．05）；FBF组SAS和SDS评分分别为37．8士10．3和39．8±11．2，低于治疗前的49．1±9．9和53．i±9．6，差异均有统计学意义（t=8．95、5．67，P均〈0．05）；治疗后两组SAS和SDS评分差异均无统计学意义（P均〉0．05）。ABF组和FBF组治疗后汉化版简明健康调查量表（SF-36）各维度积分均高于治疗前，差异均有统计学意义（P均〈0．05）；两组治疗后SF-36各维度积分差异均无统计学意义（P均〉0．05）。结论ABF和FBF治疗均可有效改善OOC患者的临床症状和心理健康状况，并提高其生命质量，但ABF疗效更佳，更有优势。

Objective To explore the effects of adaptive biofeedback training（ABF）on efficacy of clirtica[ efficacy, psychological status and life quality in patients with outlet obstruction constipation （OOC）. Methods From June 2011 to October 2014, a total of 206 patients with OOC were enrolled. They were divided into ABF group and fixed biofeedback training （FBF） group. The clinical symptoms integral, clinical efficacy, psychological status and quality of life were observed before and eight weeks after treatment. Chi-square test or t-test was performed for statistical analysis. Results A total of 138 cases completed biofeedback training and were divided into ABF group （n= 76） and FBF group （n= 62）. Before treatment, the total scores of clinical constipation symptoms of ABF and FBF groups were 10.95 ± 2.86 and 11.20±2.23, respectively, which were 2.02±1.10 and 2.98±1.19 after treatment. The total scores of both groups decreased after treatment （t = 2.60,2.45 ; both P〈 0.05）. After treatment, the difference value of total score of ABF group was 8.93 ±0.37, which was higher than that of FBF group （8.24±0.29）, and the difference was statistically significant 0=2.53, P〈0.05）. The total effective rate of ABF group 94.7% （72/76） was significantly higher than that of FBF group （85.5% 53/62）, and the difference was statistically significant X^2 = 3.426, P〈0.05）. After treatment, the self-rating anxiety scale （SAS） and self-rating depression scale （SDS） scores of ABF group were 37. 7±9. 1 and 41. 4± 7. 4, respectively, which were significantly lower than those before treatment （48.2 q-11.7 and 50.7 ± 9.6）, and the differences were statistically significant （t= 9.54 and 5.01, both P〈0.05）. The SAS and SDS scores of FBF group were 37.8± 10.3 and 39.8±11.2 after treatment, which were significantly lower than those before treatment （49.1±9.9 and 53.1±9.6）, and the differences were statistically significant （t=8.95 and 5.67, both P〈O. 05）. However, there was no statistically significant difference in SAS and SDS scores between the two groups after treatment （both P〉0.05）. After treatment, the integral of each dimension of Chinese version of the MOS 36-item short form healtly survey （SF-36） in ABF group and FBF group were both higher than those before treatment, and the differences were statistically significant （all P〈0.05）. However, there was no significant difference in the integral of each dimension of SF-36 between the two groups after treatment （all P〉0.05）. Conclusions Both ABF and FBF can effectively improve clinical symptoms, psychological health and the quality of life in patients with OOC. However, ABF seems to be more effective and superior and more advantages.