托莫西汀联合脑电生物反馈治疗儿童注意缺陷多动障碍疗效观察

目的：研究托莫西汀联合脑电生物反馈治疗儿童注意缺陷多动障碍（ADHD）的疗效。方法：对46例ADHD惠儿给予托莫西汀与脑电生物反馈治疗4个月,于治疗前后详细记录患儿注意力商数与反应控制商数中视觉、听觉商数以及进行Conners儿童行为量表父母问卷并进行评估。结果：与治疗前比较,观察组注意力商数与反应控制商数中视觉、听觉商数较治疗前明显升高,差异有统计学意义（P〈0．05）;Conners量表评分较治疗前均明显下降,差异有统计学意义（P〈0．05）。与对照组比较,治疗后注意力商数与反应控制商数中视觉、听觉商数差异均无统计学意义（P〉0．05）;治疗后Conners量表评分在多动指数、学习问题、冲动一多动、品行问题等4个方面差异均无统计学意义（P〉0．05）,而在心身障碍、焦虑两个方面评分明显下降,差异有统计学意义（P〈0．05）。结论：托莫西汀联合脑电生物反馈治疗ADHD可以更好的改善患儿的注意缺陷、多动和冲动等核心症状。     

车前番泻颗粒联合生物反馈治疗出口梗阻型便秘疗效评价

目的:评价车前番泻颗粒联合生物反馈(BF)治疗出口梗阻型便秘(OCC)的疗效。方法:66例OCC患者BF治疗一个疗程后比较治疗前后直肠压力变化,按患者意愿分为继续BF治疗组和车前番泻颗粒联合治疗组,分组治疗2月后比较2组患者临床症状改善状况。结果:BF治疗前后比较患者直肠静息压、力排结果和直肠最大耐受量显著提高(P<0.05),肛管静息压、肛门直肠缩榨压、直肠初始感觉、初始欲望、强烈欲望均无改变(P>0.05);治疗2月后,BF组和联合组患者较治疗前症状均有显著改善,且联合组优于BF组(P<0.05)。结论:BF联合车前番泻颗粒治疗方案改善患者临床症状优于单独BF治疗,是OCC的有效治疗方案。     

Rehabilitation of Fecal Incontinence After Sphincter-Saving Surgery for Rectal Cancer: Encouraging Results

Purpose  Some patients, having undergone sphincter-saving operations for rectal cancer, may suffer from fecal incontinence. This study was designed to evaluate the results of rehabilitative treatment in patients with fecal incontinence after sphincter-saving operations and to identify the negative factors that influence therapeutic success. Methods  Between January 2000 and June 2007, 88 incontinent patients (54 women; age range, 47–73 years; 69 had received a low anterior rectal resection; 19 a straight coloanal anastomosis) were included in the study. After a preliminary clinical evaluation, including the Wexner Incontinence Scale score, anorectal manometry was performed. All 88 patients underwent rehabilitative treatment according to the “multimodal rehabilitative program” for fecal incontinence. At the end of program, all 88 patients were reassessed by means of a clinical evaluation and anorectal manometry; their results were compared with the clinical and manometric data from ten healthy control subjects. Postrehabilitative Wexner Incontinence Scale scores were used for an arbitrary schedule of patients divided into three classes: Class I, good (score ≤3); Class II, fair (score >3 to ≤6); Class III, poor (score >6). Results  After rehabilitation, there was a significant improvement in the overall mean Wexner Incontinence Scale score (P < 0.03) for both surgical operation types (low anterior rectal resection: P < 0.05; coloanal anastomosis: P < 0.02). Only 21 patients (23.8 percent) were symptom-free, and 37 (42 percent) were considered Class III. A significant postrehabilitative direct correlation was found between: 1) Wexner Incontinence Scale score and degree of genital relaxation (rρ _s 0.78; P < 0.001); 2) Wexner Incontinence Scale score and irradiation (rρ _s 0.72; P < 0.01); and 3) Wexner Incontinence Scale score and pelvic (rρ _s 0.65; P < 0.01) or anal surgery (rρ _s 0.68; P < 0.01). No significant differences were found between prerehabilitative and postrehabilitative anal pressures in low anterior rectal resection and coloanal anastomosis patients. Conclusions  After rehabilitation, some patients become symptom-free, many patients show an improvement in the Wexner Incontinence Scale score, and others exhibit the highest grades of fecal incontinence. Genital relaxation, radiotherapy, and previous pelvic, and/or anal surgery are impeding factors to rehabilitative success.     

生物反馈训练可以提高超低位直肠癌内括约肌切除术后的排便功能

目的:研究生物反馈技术是否可以提高超低位直肠癌内括约肌切除术后的排便功能．方法:对16例内括约肌切除术后的患者进行生物反馈治疗,分别应用Vaizey和Wexne晰分及直肠肛管向量测压技术来评价生物反馈的效果．结果:生物反馈治疗后Vaizey和Wexner评分显著降低(6．4 vs 8．6,P<0．001;5．4 vs 7．2, P<0．001),最大收缩压(mmHg)及收缩向量容积[cm×(mmHg)2]均显著性提高(205．6±44．5 vs 143．6±46．5,P<0．001:50 664．6±8040．1 vs 13 337．0±7491．1,P<0．000,静息及收缩时的不均衡指数均显著降低(46．8±7．5 vs 58．3±7．4,P<0．001;29．9±6．7 vs 38．3±7．2,P<0．001),直肠肛管反射的阳性率也由训练前的6．3％提高至31.3％．结论:内括约肌切除术后肛管最大压力及向量容积下降,生物反馈技术可以改善部分的排便功能,可以作为提高超低位直肠癌内括约肌切除术后肛门括约肌功能的方法．     

Combined biofeedback, physiotherapy and electrostimulation for fecal incontinence

Different outcomes are reported in the literature following pelvic floor rehabilitation for fecal incontinence, possibly due to the type of procedure employed, whether biofeedback or physiotherapy or electrostimulation. The aim of the present study is to analyze the results achieved in a group of patients treated with a combination of the three procedures. Thirty-two patients (24 females) affected by fecal incontinence underwent a course of combined rehabilitation (CR); 23 of them had anal surgery prior to CR, for rectal mucosal prolapse and hemorrhoids in most cases. Eighteen had anal manometry before and after CR. Sixteen underwent anal ultrasound prior to treatment. Patients were taught perineal exercises, biofeedback was either sensory or electromyographic, and electrostimulation was performed with a 10–20 MHz endoanal probe. Twenty-seven patients were available for follow-up. The mean incontinence score improved from 4.0±0.8 to 2.1±1.7 (mean±sd) (p<0.001); 19 patients (70%) were satisfied after CR, and 11 (44%) were fully continent. Post-treatment manometry showed an increased amplitude of squeeze pressure in 50% of the cases, whereas 61% had an increase in duration, but only 27% of them had a positive clinical outcome. Rectal evacuation thresholds improved in 55% of the cases and 86% of them had a corresponding positive clinical outcome. At ultrasound, 6 patients showed intact anal sphincters and had a positive outcome following CR. Pelvic floor rehabilitation seems to be effective for the management of fecal incontinence when carried out combining different types of procedures. No significant correlation was found between manometric and clinical response to the treatment. An increase of rectal sensation may be responsible for the clinical improvement. Received: 25 August 2000 / Accepted in revised form: 20 October 2000     

生物反馈治疗脑卒中后吞咽障碍疗效的Meta分析

目的 评价生物反馈治疗脑卒中后吞咽障碍患者的疗效。 方法 计算机检索PubMed、Cochrane图书馆、EMbase、Web of Science、中国生物医学数据库、万方数据库、中国知网及维普数据库,检索时限为建库至2018年12月31日。采用RevMan 5.3软件对数据进行Meta分析。 结果 共纳入17项研究,1306例患者。Meta分析结果显示,在治疗总有效率［相对危险度（RR）=1.29,95％置信区间（CI）为（1.20,1.38）,P＜0.00001］、功能性经口摄食量表（FOIS）［均数差（MD）=0.81,95％CI（0.39,1.24）,P=0.0002］、标准吞咽功能评价量表（SSA)［MD=-5.83,95％CI（-8.48,-3.17）,P＜0.0001］、吞咽障碍特异性生活质量量表（SWAL-QOL）［MD=18.80,95％CI（15.74,21.86）,P＜0.00001］、吸入性肺炎［RR=0.46,95％CI（0.26,0.82）,P=0.008］方面,治疗组均优于对照组（P＜0.05）。 结论 生物反馈治疗能较好地改善脑卒中后吞咽障碍患者的吞咽功能及生活质量、降低肺炎发生率并提高摄食水平,但尚需进一步更多高质量、大样本的随机对照试验（RCT）加以验证。     

基于JAVA的手机网络通讯程序的开发与配置

运用JAVA开发出一种运行于手机的客户端、服务器端程序,可使存储于手机的生理信号数据通过GPRS网络发送到互联网的计算机,以便下一步进行生物反馈治疗。     

生物反馈联合神经电刺激疗法治疗儿童便失禁的研究进展

近年来生物反馈联合神经电刺激疗法作为一项新兴的治疗方法在小儿内外科、消化科、肛肠及康复外科中得以广泛应用.该文就此方法治疗儿童便失禁方丽的研究进展作一综述,包括生物反馈联合神经电刺激疗法的原理、临床应用疗效及在国内外应用的前景.     

两类功能性便秘患者行生物反馈治疗的疗效及随访比较

目的比较生物反馈治疗对两类功能性便秘（FC）的临床疗效及随访效果。方法选择2010年1月至2013年1月收治的72例FC患者,其中慢传输型便秘（STC）患者37例、出口梗阻型便秘（OOC）患者35例。所有患者均行生物反馈治疗,比较患者肛管静息压和肛管最大收缩压,并进行为期半年的随访。结果所有患者均完成2周生物反馈治疗,治疗后OOC组的肛管静息压与入院时同组和治疗后STC组相比,差异均无统计学意义;但治疗后OOC组肛管最大收缩压（146.73±24.51）mmHg明显高于入院时同组（112.51±22.5）mmHg及治疗后STC组（108.35±21.29）mmHg,P〈0.05。所有患者均随访半年。随访后OOC组的汉密尔顿焦虑量表（HAMA）评分（8.25±2.27）显著低于入院时同组（11.01±3.14）及随访后STC组（11.43±3.71）,P〈0.05。随访后OCC组的疾病不确定感量表（MUIS）评分（36.45±7.43）显著低于入院时同组（50.45±12.48）及随访后STC组（44.42±9.67）,P〈0.05。但随访后OCC组的Zung抑郁自评量表（SDS）评分与入院时同组及随访后STC组相比差异均无统计学意义。两组患者总体有效率相比,差异无统计学意义;但OOC组患者治愈率（48.57%）明显高于STC组（29.73%）,P〈0.05。结论生物反馈能有效治疗FC,对OOC的疗效更好。     

肠生物反馈对孤立性直肠溃疡综合征患者直肠黏膜血流的影响

目的研究孤立性直肠溃疡综合征(solitary rectal ulcer syndrome,SRUS)患者的直肠黏膜血流变化,并分析肠生物反馈对SRUS患者症状及直肠黏膜血流的影响.方法16例SRUS患者及20例正常对照组,于生物反馈治疗前后分别采用激光多普勒血流计检测16例SRUS患者的直肠黏膜血流量,同时采用标准问卷表分别记录治疗前后症状变化.结果16例中有12例(75%)自觉症状缓解;16例中有5例(31%)结肠镜检查示溃疡愈合;治疗前SRUS患者直肠黏膜血流量明显低于正常对照组(P＜0.01),生物反馈治疗后,治疗组直肠黏膜血流量明显上升(P＜0.01),其中自觉症状缓解者直肠黏膜血流量增加尤为显著(P=0.001).结论肠生物反馈是一种治疗SRUS患者的有效行为疗法,其治疗效果与直肠黏膜血流的增加有关.