穴位埋线联合生物反馈治疗功能性排便障碍28例临床观察

Clinical Observation on Acupoint Embedding Therapy Combined with Biofeedback Therapy in the Treatment of 28 Cases of Functional Defecation Disorder

目的观察穴位埋线联合生物反馈疗法治疗功能性排便障碍(FDD)的临床疗效及对患者心理状况的影响。方法60例FDD患者随机分成治疗组和对照组各30例。两组患者均接受生物反馈治疗,治疗组在此基础上加用穴位埋线治疗,两组均治疗8周后观察患者临床有效率,两组患者治疗前后进行主要症状评分、生存质量评分,检测肛管静息压(ARP)、肛管收缩压(AMCP)、排便压(DP)及肛门外括约肌收缩持续时间(ALCT),比较焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果治疗组临床有效率(92.86%)明显高于对照组(69.23%,P<0.05)。治疗后两组主要症状评分、DP均较治疗前明显降低,ALCT明显升高(P<0.05),其中治疗后排便费力感,排便时间,下坠、不尽、胀感及腹胀评分治疗组明显低于对照组(P<0.05)。治疗组生存质量评分,SAS、SDS评分及对照组SAS评分明显低于治疗前(P<0.05)。治疗后治疗组生存质量评分、SDS评分、AMCP、DP明显低于对照组,ALCT明显升高(P<0.05)。结论穴位埋线联合生物反馈疗法能够更有效地从临床症状、肛管直肠压力及心理状态等方面提高FDD患者的临床疗效。

Objective To observe the clinical effect of acupoints embedding therapy combined with biofeedback therapy on patients with functional defecation disorder(FDD)and its effects on psychological status.Methods A total of 60 patients with FDD were randomly divided into a treatment group of 30 cases and a control group of 30 cases.Patients in both groups received biofeedback therapy,and the treatment group was treated with acupoints embedding additionally.Both groups were treated for 8 weeks.The clinical efficiency,constipation symptom,patient-assessment of constipation quality of life(PAC-QOL)of both groups before and after treatment were observed.Anal rest pressure(ARP),anal maximum contraction pressure(AMCP),defecation pressure(DP),and anal maximum contraction pressure(ALCT)were detected.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were compared.Results Clinical effective rate of the treatment group(92.86%)was obviously higher than that of the control group(69.23%),(P<0.05).The main symptoms scores,DP of both groups were decreased after treatment,and ALCT was significantly increased(P<0.05).Among them,after treatment,hard feelings of defecation,defection time,straining feeling,endless defecation,swelling and bloating symptoms scales in the treatment group were lower than the control group(P<0.05).PAC-QOL,SAA and SDS in the treatment group and SAS in the control group were significantly lower than before treatment(P<0.05).After treatment,PAC-QOL,SDS,AMCP,DP in the treatment group were significantly lower than the control group,and ALCT was significantly increased(P<0.05).Conclusion Acupoint embedding therapy combined with biofeedback therapy can more effectively improve clinical efficacy of FDD patients from clinical symptoms,anorectal pressure and psychological state.