针药联合生物反馈治疗功能性便秘疗效回顾性分析

Retrospective Analysis of the Efficacy of Acupuncture and Traditional Chinese Medicine Combined with Biofeedback in treating Functional Constipation

目的:分析针药联合生物反馈治疗功能性便秘(FC)的近远期疗效及其相关因素。方法:通过电话随访方式,对2015年6月至2017年11月在南京中医药大学附属医院南京中医院行针药联合生物反馈治疗的FC患者进行回顾性分析,完成便秘症状积分评估,评价患者治疗后(近期)及随访结束时(远期)的有效率(疗效指数≥30%)及满意率。共计72例患者纳入研究,随访时间4~34(中位数14)个月。结果:治疗后及随访期间患者便秘症状积分较治疗前降低(P<0.05),随访期间患者便秘症状积分较治疗后有所上升(P>0.05)但优于治疗前。治疗后有效率和满意率处于较高水平,随访期间有所降低,其中满意率降低更多。62例治疗有效的患者,治疗后到随访期间疗效下降≤5%及≤30%的人数分别占总人数的51.61%和66.12%,各中医证型治疗后及随访期间有效率差异无统计学意义(P>0.05)。年龄、病程、治疗次数与疗效指数之间不存在线性关系。结论:针药联合生物反馈治疗FC,近远期疗效较稳定,患者满意度尚可。年龄大小及病程长短不影响疗效估计。患者满意度的高低取决于疗效及护理方式。

Objective:To analyze the short-term and lone-term efficacy and related factors of acupuncture,traditional Chinese medicine combined with biofeedback in the treatment of functional constipation(FC).Methods:A retrospective analysis of patients with FC who underwent acupuncture and Chinese medicine combined with biofeedback therapy in the Nanjing Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Chinese Medicine from June 2015 to November 2017 was conducted by telephone follow-up. The constipation symptom score assessment was completed. Efficacy(effectiveness index ≥ 30%) and satisfaction rate were evaluated after treatment(short-term) and at the end of follow-up(long-term). A total of 72 patients were enrolled in the study,with a follow-up of 4 to 34(median 14) months. Results:The clinical manifestations of the patients were mostly difficulty in defecation and prolonged defecation time. After treatment and during follow-up,the scores of constipation symptoms were lower than those before treatment(P< 0.05). During the follow-up period,the scores of constipation symptoms increased after treatment(P> 0.05) but better than before treatment. After treatment,the efficiency and satisfaction rate were at a high level,which decreased during the follow-up period,and the satisfaction rate decreased more. Among the 62 patients with effective treatment,the number of patients who decreased by ≤5% and ≤30% after treatment to the follow-up period accounted for 51.61% and 66.12% of the total number respectively. There was no significant difference in the efficiency of each TCM syndrome type after treatment and during follow-up(P< 0.05). There is no linear relationship between age,duration of disease,number of treatment and efficacy index. Conclusions:Acupuncture and Chinese medicine combined with biofeedback treatment of FC,the efficacy of the short and long term is significant and stable,and patient satisfaction is high. The age and duration of disease don’t affect the efficacy. The level of patient satisfaction is related to the efficacy and the nursing method.