联合物理训练对改善功能性便秘患者胃肠道症状及生活质量的效果分析

The Effect of the Combined Physiotherapy on Gastrointestinal Symptoms and Quality of life on Patients with Functional Constipation

目的探讨联合物理疗法对功能性便秘患者的胃肠道症状及生活质量的影响。方法60例功能性便秘患者随机分为两组:对照组(30例)予以常规传统药物治疗,干预组(30例)在药物基础上同时予以联合物理训练。运用采用胃肠道症状分级评分量表(GSRS)和便秘患者生活质量特异量表(PAC-QOL)分别评价患者胃肠道症状和生活质量。6周后,对两组患者胃肠道症状及生活质量予以比较。结果干预组与对照组相比:(1)干预组患者胃肠道症状明显改善,胃肠道症状总积分,便秘、消化不良、反流症状较对照组降低(P<0.05或0.01);(2)干预组患者生活质量提高,PAC-QOL总平均分,躯体不适,担心和焦虑较对照组有降低(P<0.05);患者心理社会不适及满意度虽较对照组有所改善,但无统计学差异(P>0.05)。结论联合物理训练可以有效改善功能性便秘患者胃肠道症状尤其是便秘、消化不良及反流症状,提高患者生存质量。

Objective To investigate the effect of the combined physiotherapy on gastrointestinal systems and quality of life on patients with functional constipation(FC). Methods 60 Patients with functional constipation according to the Rome Ⅲ criteria were randomized to physiotherapy or medical treatment. In the physiotherapy group, exercises(isometric training of the abdominal muscles, diaphragmatic breathing exercises and abdominal massage) were employed twice a week by a trained physiotherapist, with laxatives. Patients in the medication group were only given laxatives. Gastrointestinal Symptoms Rating Scale(GSRS) and Patient Assessment of Constipation Quality of Life Questionnaire(PAC-QOL) were used to assess the gastrointestinal function and quality of life, alternatively. After 6 weeks, the gastrointestinal function and quality of life were compared between two groups. Results(1) Combined physiotherapy significantly decreases severity of gastrointestinal symptoms assessed with GSRS, according to total score(P=0.048), constipation syndrome(P=0.009), indigestion syndrome(P=0.045) and reflux syndrome(P=0.045).(2) Combined physiotherapy significantly improves the FC patients’ quality of life with PAC-QOL, according to total score(P=0.044), physical discomfort(P=0.049), and worries and concerns(P=0.041). Conclusions Combined physiotherapy can decrease severity of gastrointestinal symptoms, especially constipation, indigestion and reflux syndrome. Combined physiotherapy can improve FC patients’ quality of life.