Therapeutic effect of different treatment methods on functional anorectal pain

Objective： To observe the clinical efficacy of oral traditional Chinese medicine （Jiaweitiaoqi decoction）, electroacupuncture, biofeedback, and combined treatment on functional anorectal pain （FAP）. Methods： A total of 200 patients with FAP were randomly divided into 4 groups, with 50 patients in each group. Group 1 was given oral Jiaweitiaoqi decoction; group 2 was given electroacupuncture at the lumbosacral acupoints; group 3 was given biofeedback training; and group 4 was given combined treatment. The numeric rating scale （NRS）, Short Form-36 （SF-36） quality of life scale, static pressure of the anal canal, and maximum systolic pressure were observed in the 4 groups. Results： The observation indices of the 4 groups were all improved after treatment compared with those before treatment, and the fourth group showed the most obvious improvement. Regarding NRS scores, the static pressure of the anal canal, and maximum systolic pressure, group 4 had lower values than the other 3 groups （P 〈 0.05 for all）. In the SF-36 quality of life score, group 4 showed a higher value than the other 3 groups （P 〈 0.05）. Conclusion： Non-drug therapy including acupuncture and physical exercise can enhance the clinical efficacy of single Chinese medicine in the treatment of FAP .

Action mechanism of Zhitong Rushen Decoction in treating functional anorectal pain based on network pharmacology

Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemical components and selected targets related to the ten traditional Chinese medicine(TCM)herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database,OMIM database,disease targets of FAP were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the active ingredients-targets interacted network.GO enrichment analysis and KEGG enrichment analysis of targets were based on R language.Results:Four main chemical components including quercetin,wogonin,fisetin and kaempferol were screened,and four key targets including ESR1、NOS2、PGR and CHRM3 were identified.In GO enrichment analysis,66 molecular function entries,1040 biological process entries,26 cell component entries were obtained.KEGG pathway enrichment analysis showed that zhitong rushen decoction played a therapeutic role in functional anorectal pain by regulating AGE-RAGE signaling pathway in diabetic complications,Bladder cancer,Estrogen signaling pathway,HIF-1 signaling pathway.Conclusion:Zhitong rushen decoction for the treatment of functional anorectal pain may be related to its multi-component effect on multiple targets and multiple signaling pathways,providing theoretical basis for further study of active ingredients and mechanism of action.

Thirty-six cases of functional anorectal pain treated with heat-sensitization moxibustion

Objective To explore the clinical effects of heat-sensitizing moxibustion on functional anorectal pain. Methods Thirty six patients with functional anorectal pain were treated with moxibustion on heat-sensitive acupuncture points.The heat-sensitized points include Chángqiáng（长强 GV l）, Cìliáo（次髎 BL 32）, Yāoshū（腰俞 GV 2）, and local perianal points. A course of treatment consisted of treatment at each heat-sensitized point for 15 min once per day for 10 days. The therapeutic effects were observed after continuous treatment for 3 treatment cycles. Results Twelve cases were cured, eleven cases had effective results, and 3 cases were ineffective. The total effectiveness rate was 91.7%. The visual analog scale（VAS） total score was 6.1±1.52 before treatment and was 1.63±1.05 after treatment, showing a statistically significant difference（P〈0.01）. Conclusion Heat-sensitization moxibustion can significantly relieve functional anorectal pain.

Efficacy evaluation of electroacupuncture at Dong’s points combined with biofeedback in the treatment of functional anorectal pain

Objective:To investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.Methods:Sixty patients diagnosed functional anorectal pain were divided into three groups by random number table,namely electroacupuncture group,biofeedback group,and combination group,with 20 patients in each.In the electroacupuncture group,the electroacupuncture at Dong’s points Sānqí(三其穴),including Qímén(其门),Qíjiǎo(其角),and Qízhéng(其正),and Línggǔ(灵骨),Dàbái(大白),Chángmén(肠门)of both sides was given;in the Biofeedback group,the biofeedback therapy was adopted;in the combination group,the electroacupuncture and biofeedback therapy were used.All patients were treated once a day,30 min each time,10 consecutive treatments as one treatment course,and the therapeutic effect was evaluated after 3 treatment courses.The observation indexes after the intervention:Visual analogue Scale(VAS)score,SF-36 Quality of Life Scale score,Self-rating Anxiety Scale(SAS)score,Self-rating Depression Scale(SDS)score,Anorectal manometry,Clinical efficacy,and patients’adverse reactions.Results:After treatment,the pain of patients in the three groups was alleviated than that before treatment,VAS score,SAS score,SDS score,and anorectal pressure were decreased(P<0.05),and SF-36 Quality of Life Scale score was increased(P<0.05).After treatment,in the combination group,the VAS scores,SAS scores,SDS scores,and Anal-rectal pressure scores were lower than those in the other two groups(P<0.05),and SF-36 Quality of Life Scale scores were higher than those in the other two groups(P<0.05),the total effective rate was 80.0%(16/20),which was significantly higher than that of the electroacupuncture group(55.0%,11/20)and the biofeedback group(40.0%,8/20)(both P<0.05).No adverse reactions occurred in all three groups.Conclusion:Electroacupuncture at Dong’s points combined with biofeedback therapy has a significant effect on functional anorectal pain.The combined application of electroacupuncture and biofeedback therapy has a synergic action,and the analgesic effect is better than that of only using electroacupuncture or biofeedback therapy.