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Prospective study of biofeedback retraining in patients with chronic idiopathic functional constipation

查看全文 作　　者：[1]JunWang;Mao-[2]HongLuo;Qing-[3]HuiQi;Zuo-[3]LiangDong 高影响力作者 机构地区：[1]DepartmentofColorectalSurgery,TianjinBinjiangHospital,Tianjin300022,China;[2]DepartmentofPublicHealth,TianjinMedicalUniversity.Tianjin300070,China;[3]DepartmentofGeneralSurgery,TianjinMedicalUniversityHospital,Tianjin300050,China高影响力机构 出　　处：《World Journal of Gastroenterology》索引2003年第9卷第9期,共5页高影响力期刊 基　　金：the Natural Science Foundation of Tianjin Health Bureau,No.99KY2D07 摘　　要：AIM: To determine the efficacy and long-term outcome of biofeedback treatment for chronic idiopathic constipation and to compare the efficacy of two modes of biofeedback (EMG-based and manometry-based biofeedback).METHODS: Fifty consecutive contactable patients included 8 cases of slow transit constipation, 36 cases of anorectic outlet obstruction and 6 cases of mixed constipation. Two modes of biofeedback were used for these 50 patients, 30 of whom had EMG-based biofeedback, and 20 had manometrybased biofeedback. Before treatment, a consultation and physical examination were done for all the patients, related information such as bowel function and gut transit time was documented, psychological test (symptom checkJist 90, SCL90)and anorectic physiological test and defecography were applied. After biofeedback management, all the patients were followed up. The Student′s t-test, chi-squared test and Logistic regression were used for statistical analysis.RESULTS: The period of following up ranged from 12 to 24months (Median 18 months). 70% of patients felt that biofeedback was helpful, and 62.5% of patients with constipation were improved. Clinical manifestations including straining, abdominal pain, bloating, were relieved, and less oral laxative was used. Spontaneous bowel frequency and psychological state were improved significantly after treatment. Patients with slow and normal transit, and those with and without paradoxical contraction of the anal sphincter on straining, benefited equally from the treatment. The psychological status rather than anorectal test could predict outcome. The efficacy of the two modes of biofeedback was similar without side effects.CONCLUSION: This study suggests that biofeedback has a long-term effect with no side effects, for the majority of patients with chronic idiopathic constipation unresponsive to traditional treatment. Pelvic floor abnormalities and transit time should not be the selection criteria for treatment. 关 键 词：先天性功能性便秘 生物反馈训练 治疗方法 临床疗效
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