摘要
目的 观察骶神经磁刺激联合生物反馈(BF)加电针治疗轻中度混合型便秘的临床疗效。方法 选取凉山彝族自治州第一人民医院长安分院肛肠科2020年12月至2022年1月收治的40例轻中度混合型便秘患者为研究对象。采用骶神经磁刺激联合BF加电针治疗,治疗3个疗程,参考中华医学会外科学分会肛肠外科学组的便秘症状及疗效评估方法进行便秘症状评分,比较治疗前及治疗1、2、3个疗程后便质评分、便意感次数、排便次数、腹胀程度。采用患者评价便秘生活质量问卷(PAC-QOL)评估法比较治疗前、治疗3个疗程后患者身体不适、心理不适、便秘相关的焦虑和关心及对治疗的满意度。结果 与治疗前比较,不使用开塞露或利那洛肽患者治疗1、2、3个疗程便质评分高分占比呈上升趋势,差异有统计学意义(P<0.001)。与治疗前比较,治疗1、2、3个疗程患者排便困难、过度用力排便缓解发生率逐渐降低,粪便性状4~5型患者占比呈上升趋势,排便时间每次短于10 min的患者占比呈上升趋势(P<0.001);下坠、不尽、胀感患者占比呈下降趋势(P<0.05);排便频率在1~3 d 1次的患者占比呈上升趋势(P<0.001);排便频率在>3~6 d 1次的患者占比呈下降趋势(P<0.05);腹胀无显著变化(P>0.05);无措施不解患者占比呈下降趋势(P<0.05)。与治疗前比较,治疗后患者身体不适、心理不适、便秘相关的焦虑和关心、满意度评分明显下降,差异均有统计学意义(P<0.05)。治疗结束时临床痊愈24例,好转16例,无效0例;治疗后1个月随访,临床痊愈23例,好转15例,无效2例;治疗后3个月随访,临床痊愈21例,好转14例,无效5例。结论 骶神经磁刺激联合BF加电针治疗轻中度混合型便秘可有效提高治疗效果,改善患者生活质量。
Objective To observe the clinical effect of sacral nerve magnetic stimulation combined with biofeedback(BF) electroacupuncture on mild to moderate mixed constipation.Methods A total of 40 patients with mild to moderate mixed constipation admitted to the Department of Anorectal, Chang′an Branch of Liangshan Yi Autonomous Prefecture First People′s Hospital from December 2020 to January 2022 were selected as the research objects.Sacral nerve magnetic stimulation combined with BF electroacupuncture was used for three courses of treatment.Constipation symptoms were scored according to the methods of constipation symptoms and efficacy evaluation of Anorectal Surgery Group, Surgery Branch of Chinese Medical Association.The patient assessment of constipation-quality of life(PAC-QOL) questionnaire was used to compare the score of stool quality, frequency of stool sensation, frequency of defecation, degree of abdominal distension and quality of life before treatment and after one, two and three courses of treatment.Results Compared with before treatment, after one, two and three courses of treatment, the proportion of high score of stool quality in patients who did not use glycerin enema or linalotide showed an increasing trend, and the difference was statistically significant(P<0.001).Compared with before treatment, after one, two and three courses of treatment, the incidence of difficulty in defecation and relief of excessive force defecation gradually decreased, the proportion of patients with fecal traits type 4-5 showed an increasing trend, and the proportion of patients with defecation time less than 10 minutes each time showed an increasing trend(P<0.001).The proportion of patients with sagging, incomplete and distension showed a decreasing trend(P<0.05).The proportion of defecation frequency once in one to three days showed an increasing trend(P<0.001).The frequency of defecation once in three to six days showed a decreasing trend(P<0.05).There were no significant change in abdominal distension(P>0.05).The proportion of patients without any measures showed a decreasing trend(P<0.05).Compared with before treatment, the patients′ physical discomfort, psychological discomfort, anxiety and concern related to constipation, satisfaction score and total scores of patients decreased significantly after treatment, with statistical significance(P<0.05).At the end of treatment, 24 cases were cured, 16 cases were improved and 0 cases were ineffective.After one month of treatment, 23 cases were cured, 15 cases were improved and 2 cases were ineffective.After three months of follow-up, 21 cases were cured, 14 cases were improved and 5 cases were ineffective.Conclusion Sacral nerve magnetic stimulation combined with BF electroacupuncture in the treatment of mild to moderate mixed constipation can effectively improve the therapeutic effect and improve patients′ quality of life.
作者
李馨兰
张兵
饶佳
吴涛
太宇航
LI Xinlan;ZHANG Bin;RAO Jia;WU Tao;TAI Yuhang(Department of Anorectal,Chang'an Branch of Liangshan Yi Autonomous Prefecture First People's Hospital,Xichang,Sichuan 615000,China)
出处
《现代医药卫生》
2023年第4期580-584,共5页
Journal of Modern Medicine & Health
基金
四川省中医药管理局科学技术立项项目资助课题(2021MS428)。
关键词
混合型便秘
骶神经磁刺激
生物反馈治疗
电针治疗
生活质量
Mixed constipation
Sacral nerve magnetic stimulation
Biofeedback therapy
Electroacupuncture therapy
Quality of life
