首页|肌电生物反馈联合电刺激治疗功能性肛门直肠痛的个体化设计初探

肌电生物反馈联合电刺激治疗功能性肛门直肠痛的个体化设计初探

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目的:分析两种不同模式的生物反馈联合电刺激方案对功能性肛门直肠痛及其伴随的排便困难等症状的临床疗效,从而为制订个体化治疗方案提供参考.方法:将2022年1-7月于重庆市中医院肛肠科就诊的111例功能性肛门直肠痛患者按是否伴随排便困难分为两类.将第一类伴随排便困难症状的患者60例随机等分为两组,分别以生物反馈联合电刺激模式一、生物反馈联合电刺激模式二治疗;将第二类无伴随症状的患者51例随机分为两组,分别以生物反馈联合电刺激模式一治疗25例、生物反馈联合电刺激模式二治疗26例.观察治疗后各组病例症状改善、功能恢复情况及盆底功能Glazer评估结果的变化情况.结果:经过1个疗程生物反馈联合电刺激治疗,各组患者盆底功能Glazer评估结果均优于治疗前(P＜0.05).使用生物反馈联合电刺激模式一治疗的30例伴随排便困难症状患者,总有效率为93.33％(28/30);以模式二治疗的30例患者,总有效率为73.33％(22/30)(P＜0.05).无伴随排便困难症状的51例患者中,使用生物反馈联合电刺激模式一治疗25例患者,总有效率为68.00％(17/25);以模式二治疗26例,总有效率为96.16％(25/26)(P＜0.05).结论:生物反馈联合电刺激治疗功能性肛门直肠痛疗效显著.对于伴有排便困难症状的患者,使用以电刺激为主、辅以Kegel训练的模式一的疗效优于模式二.而无排便困难症状的患者,使用先以电刺激锻炼肛门括约肌力量,再以Kegel训练的模式二的疗效优于模式一.
Individualized design of myoelectric biofeedback combined with electrical stimulation in the treatment of functional anorectal pain
Objective:To analyze the clinical efficacy of two different models of biofeedback combined with electrical stimula-tion in the treatment of functional anorectal pain and its accompanying symptoms such as defecation difficulties,so as to provide reference for making individual treatment programs.Methods:A total of 111 patients with functional anorectal pain admitted to the Proctology Department of Chongqing Hospital of Traditional Chinese Medicine from January to July 2022 were divided into two cat-egories according to whether they were accompanied by defecation difficulties.The first group of 60 patients with difficulty in defecation symptoms were randomly divided into 2 groups,who were treated with biofeedback combined with electrical stimulation mode 1 and bio-feedback combined with electrical stimulation mode 2 respectively.The second category of patients with no accompanying symptoms,51 cases,were randomly divided into two groups,25 cases were treated with biofeedback combined with electrical stimulation mode 1,and 26 case were treated with biofeedback combined with electrical stimulation mode 2.The improvement of symptoms,functional recovery and the change of Glazer evaluation results of pelvic floor function in each group were observed after treatment.Results:After one course of biofeedback combined with electrical stimulation,the Glazer evaluation results of pelvic floor function in all groups were better than those before treatment(P＜0.05).The total effective rate was 93.33％(28/30)in 30 patients treated with biofeedback combined with elec-trical stimulation mode 1.In 30 patients treated with mode 2,the total effective rate was 73.33％(22/30)(P＜0.05).Among the 51 patients without symptoms of difficulty in defecation,25 patients were treated with biofeedback combined with electrical stimulation mode 1,and the total effective rate was 68.00％(17/25);26 patients were treated with mode 2,and the total effective rate was 96.16％(25/26)(P＜0.05).Conclusions:Biofeedback combined with electrical stimulation is effective in treating functional anorectal pain.For patients with difficulty in defecation,the mode 1 based on electrical stimulation and supplemented with Kegel training is more effective than mode 2.For the patients without difficulty in defecation,the effect of mode 2,electric stimulation for anal sphincter strength followed by Kegel training,is better than mode l.

Bilolgical feedbackElectrostimulationAnorectal painIndividualized treatment

陶瑞雪、张琪、刘凯、张桢

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湖南中医药大学,湖南 长沙,410000

重庆市中医院,重庆,400000

重庆医科大学,重庆,400000

生物反馈 电刺激 肛门直肠痛 个体化治疗

重庆市自然科学基金博士后面上项目重庆市自然科学基金面上项目(2022)重庆市科研机构绩效激励引导专项(2021)中国博士后科学基金国家自然科学基金青年基金

cstc2021jcyjbshX0144CSTB2022NSCQ-MSX0392jxyn2021-2-142022MD71370582105032

2024

10.3969/j.issn.1674-7860.2024.06.034

中医临床研究
中华中医药学会

中医临床研究

影响因子：0.839
ISSN：1674-7860
年,卷(期)：2024.16(6)