生物反馈训练疗法在老年功能性便秘患者中的应用效果

Effect of biofeedback therapy fur functional constipation in elderly patients

目的探讨生物反馈训练疗法对治疗老年人功能性便秘的临床价值和应用效果。方法随机选择在我院普外科门诊就诊且符合罗马Ⅲ标准的78例老年功能性便秘患者，分成试验组和对照组进行研究，对照组39例患者给予常规治疗联合口服聚乙二醇，试验组39例在对照组基础上接受生物反馈训练治疗，完成4个疗程后进行直肠动力学疗效评估，比较两组患者便秘症状积分、肛门直肠动力学指标及临床效果。结果试验组治疗后粪便性状、排便困难、排便时间及排便频率评分均优于对照组（t=5．670、4．740、4．170、5．530，P=0．016、0．034、0．039、0．022）；试验组临床有效率94．9％（37／39），高于对照组71．8％（2S／39）（x2=4．493，P=0．030）；两组治疗后3s收缩幅度（3SC）、10S收缩幅度（10SC）水平较治疗前均上升，10S松弛压力（10SR）水平下降（均P〈0．05），且试验组变化幅度优于对照组，组间比较差异有统计学意义（均P〈0．05）。结论生物反馈训练治疗对老年功能性便秘患者有确切的效果，辅助生物反馈训练能较好地缓解老年人便秘症状、增强排便功能的自控力、促进排便，疗效优于单纯服用促胃肠动力药物。

Objective To evaluate the clinical value and effect of biofeedback training therapy for functional constipation in elderly patients. Methods A total of 78 elderly patients with functional constipation were treated at the People＇s Hospital of Pudong New Area, and were divided randomly into two groups. The control group （n= 39） received routine treatment plus oral polyethylene glycol, while the experimental group （n = 39 ） received biofeedback training treatment in addition to what was offered to the control group. After treatment, constipation symptom scores, anorectal dynamic parameters and clinical effects were compared between the two groups. Results The scores on excrement characteristics, defecation difficulty, and time and frequency of defecation were better in the experimental group than those in the control group （t = 5. 670,4. 740,4. 170,5. 530 ; P = 0. 016, 0.034,0.039, 0.022, respectively）.The overall effectiveness rate was 94. 9% （37/39） in the experimental group, which was higher than that （ 71.8 % , 28/39） in the control group （x2 = 4. 493, P=0. 030）. Meanwhile,the levels of 3SC and 10SC in the two groups were higher than those before treatment,but the level of 10SR was lower than that before treatment （all P〈0.05）. Moreover, improvement in 3SC, 10SC and 10SR were more significant in the experiment group than in the control group （all P 〈 0.05 ）. Conclusions Biofeedback training therapy is safe and effective for elderly patients with constipation to relieve constipation symptoms, enhance control of defecation and promote defecation.