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目的研究生物反馈治疗前后功能性便秘患者肛管直肠动力参数的改变,探索生物反馈治疗功能性便秘的临床疗效。方法对42例慢性功能性便秘患者给予生物反馈治疗,治疗前后进行临床评估、肛管直肠测压及肌电图检查并进行对比分析。结果生物反馈治疗后患者临床症状改善,肛管直肠测压显示直肠感觉阈值、直肠最大容量感觉阈值、肛管直肠抑制反射阈值有所下降(P<0.05),而直肠静息压、肛管静息压及肛管最大收缩压虽有增高,但与治疗前相比差异无统计学意义(均P>0.05),肌电图显示盆底肌和腹肌的矛盾运动消失。结论功能性便秘患者存在肛直肠动力异常,有盆底肌和腹肌的矛盾运动,生物反馈治疗能有效改善功能性便秘患者的肛直肠动力障碍。
Objective To study the changes of anorectal motility parameters in patients with functional constipation before and after biofeedback and to explore the clinical efficacy of biofeedback in treating functional constipation. Methods A total of 42 patients with chronic functional constipation were treated with biofeedback. The clinical evaluation, anal canal pressure and EMG examination before and after treatment were compared and analyzed. Results After treatment with biofeedback, clinical symptoms were improved. Anal canal rectal manometry showed rectal sensation threshold, maximal sensory threshold of rectum, decreased rectal suppression reflex threshold (P <0.05), and rectal resting pressure, anal stability Although the maximum systolic blood pressure and anal canal systolic blood pressure increased, but no significant difference compared with before treatment (all P> 0.05), EMG showed contradiction between pelvic floor muscle and abdominal muscle disappeared. CONCLUSIONS: Patients with functional constipation have abnormalities of anorectal motility, contradictory pelvic floor muscles and abdominal muscles, and biofeedback therapy can effectively improve the dysfunction of the anorectal motility in patients with functional constipation.