自适应式与固定式生物反馈训练对出口梗阻型便秘患者肛直肠功能和心理状态的影响

目的:探讨自适应式与固定式生物反馈训练对出口梗阻型便秘(OOC)患者肛直肠功能和心理状态的影响。方法:选取2017年4月～2019年12月期间晋城大医院收治的OOC患者98例,根据随机数字表法将患者分为对照组(n=49,固定式生物反馈训练)和研究组(n=49,自适应式生物反馈训练),比较两组患者疗效、肛直肠功能、排便次数、排便困难评分和心理状态。结果:研究组治疗8周后的临床总有效率93.88%(46/49),高于对照组的77.55%(38/49)(P0.05)。两组治疗8周后排便次数增加,排便困难评分降低(P0.05),研究组治疗8周后排便次数多于对照组,排便困难评分低于对照组(P0.05)。两组治疗8周后直肠肛门抑制反射阈、肛管静息压均较治疗前下降,模拟排便时直肠肛管压力梯度较治疗前升高(P0.05)。两组治疗8周后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均较治疗前下降,且研究组低于对照组(P0.05)。结论:与固定式生物反馈训练相比,自适应式生物反馈训练可获得与之效果相当的肛直肠功能改善程度,并可进一步减轻患者症状及改善心理状态,疗效显著。

Effect of Adaptive and Fixed Biofeedback Training on Anorectal Function and Mental State in Patients with Outlet Obstruction Constipation

ABSTRACT Objective: To investigate the effect of self-adaptive and fixed biofeedback training on anorectal function and mental state in patients with outlet obstructive constipation (OOC). Methods: 98 patients with OOC who were admitted to Jincheng General Hospital from April 2017 to December 2019 were selected, they were randomly divided into two groups: control group (n=49, fixed biofeedback training) and study group (n=49, adaptive biofeedback training). The efficacy, anorectal function, defecation frequency, defecation difficulty score and psychological state of the two groups were compared. Results: The total effective rate of the study group after 8 weeks was 93.88% (46/49), higher than 77.55% (38/49) of the control group (P<0.05). The number of defecation increased and the score of defecation difficulty decreased in the two groups at 8 weeks after treatment (P<0.05). 8 weeks after treatment, the rectal and anal inhibition reflex threshold and anal resting pressure of the two groups were lower than those before treatment, and the rectal and anal pressure gradient during simulated defecation was higher than that before treatment (P<0.05). 8 weeks after treatment, the scores of self rating Anxiety Scale (SAS), self rating Depression Scale (SDS) in the two groups were lower than those before treatment, and the scores in the study group were lower than those in the control group (P<0.05). Conclusion: Compared with the fixed biofeedback training, the adaptive biofeedback training can achieve the same effect of anorectal function improvement, and further reduce the symptoms and improve the psychological state of patients, with significant effect.