生物反馈治疗老年慢性便秘疗效分析

便秘为临床中常见的症状,严重影响患者的工作和生活质量,慢性便秘尤为突出,其在老年人的发病率较一般人群高。为缓解老年慢性便秘患者的痛苦,我们对北京军区总医院消化科2009年至2011年60岁以上老年慢性便秘患者给予了生物反馈治疗,观察结果总结如下。     

生物反馈方法治疗冠心病合并便秘患者的疗效

目的：观察生物反馈方法治疗冠心病合并慢性功能性便秘（CIC）患者症状评分和心绞痛临床疗效变化。方法：48例冠心病合并CIC患者接受了生物反馈方法治疗,治疗前后接受“便秘症状及疗效评估问卷”调查,冠心病疗效指标评估,并与49例常规治疗同病患者（对照组）比较。结果：治疗前两组患者便秘症状总分和各分项评分无显著差异（P均〉0．05）,生物反馈治疗组治疗后的便秘症状总分和各分项评分均明显优于治疗前和对照组（P〈0．05～0．01）。同时其冠心病总有效率（91．66％）明显优于对照组的71．42％（χ^2=6．572;P〈0．05）。结论：生物反馈方法可明显改善冠心病合并慢性功能性便秘患者的便秘症状和心绞痛症状。     

生物反馈治疗慢性便秘的疗效评价

生物反馈治疗以其高疗效、无副作用的特点,成为慢性便秘、特别是功能性排便障碍的一线治疗方案之一。许多因素可能影响对生物反馈治疗效果的判断。本文将就此进行综述,总结客观评价生物反馈疗效时需要注意的方面,为将生物反馈治疗更好地应用于临床提供参考。     

短疗程生物反馈训练治疗慢性功能性便秘的临床研究

我们应用短疗程生物反馈治疗慢性功能性便秘病人 ,取得较好的疗效 ,现报道如下。1　材料与方法1.1　一般资料　 5 3例慢性功能性便秘患者 ,女 4 5例 ,男 8例 ,年龄 2 1～ 72岁 ,平均 4 3.8岁。患者均做过结肠镜检查 ,排除了大肠、肛门器质性疾病。便秘的诊断均符合我国 1999年 5月制定的《便秘诊治暂行标准》。1.2　仪器　SPSOrionPC/ 12EMG肌电生物反馈训练治疗仪为MedtronicSynectics公司生产。其中主要包括 2个非损伤性电极、训练治疗软件、计算机。1.3　生物反馈训练治疗方法　首先反复向患者讲解正常的排便机制和治疗过程及目的 ,…     

生物反馈对功能性便秘患者症状和心理状态的影响

背景：功能性便秘（FC）是一种消化系统常见的功能性胃肠病，生物反馈是其有效治疗方法之一。目的：探讨生物反馈治疗对FC患者临床症状和心理状态的影响。方法：对78例符合FC罗马Ⅱ标准的患者行生物反馈训练，应用症状积分量表、结肠转运时间、Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）等评定患者治疗前后临床症状和心理状态的综合改善情况。结果：生物反馈治疗FC的总有效率为79．5％。生物反馈治疗前，与中国常模相比，FC患者的焦虑（39±8对31±13）和抑郁（52±9对42±11）积分显著升高（P均〈0.01）。生物反馈治疗后，患者焦虑（33±7对39±8）和抑郁（46±8对52±9）显著改善（P均〈0．01）。结论：生物反馈不仅可改善FC患者的临床症状，还可改善其异常心理状态。     

生物反馈治疗老年人功能性便秘86例疗效

慢性功能性便秘(chronic f unctional constipation,CFC)在我国60岁以上老年人中发病率占10%～23%[1],严重影响现代人生活质量,且在结肠癌、肝性脑病、乳腺疾病、早老性痴呆等疾病的发生中有重要的作用,在急性心肌梗死、脑血管意外时可导致死亡.生物反馈训练治疗具有简便、无痛、无创、安全的特点,是一种治疗CFC的新兴生物行为治疗方法,本文应用生物反馈训练治疗老年人慢性功能性便秘,临床疗效较好.     

功能性便秘的生物反馈治疗及评价

生物反馈治疗最早创立于20世纪60年代,随着胃肠病学的发展和行为疗法在胃肠疾病治疗中的应用研究,生物反馈治疗的作用日趋显著,尤其广泛应用于FC、功能性大便失禁(functional fecal inconti-nence,FI)等功能性结直肠肛门病。1生物反馈治疗FC的机制和方法1.1机制生物反馈治疗是松弛疗法与生物反馈技术的结合;是在行为疗法基础上发展的一种新的心理治疗技术,即利用仪器描记人体正常情况下意识不到的、与心理生理活动有关的某些生物信息(如肌电活动、脑电波、皮肤温度、心率、血压等),并转换成可察觉到的声、光等反馈信号,使人体学会有意识…     

生物反馈治疗功能性排便障碍疗效的影响因素分析

目的 研究影响排便障碍型便秘患者生物反馈治疗疗效的影响因素,并提供可以预判疗效的统计学方程.方法 回顾分析2011年2月～2012年12月在我院进行生物反馈治疗的46例排便障碍型便秘患者的临床资料,分析各项数据与治疗有效率的相关性.结果 便秘患者病程、肛管最大收缩压、排便肛管压、治疗次数与生物反馈疗效之间存在显著相关.结论 便秘患者病程、肛管最大收缩压、排便肛管压、治疗次数可作为临床生物反馈疗效预判的依据.     

慢性功能性便秘肛直肠压力检测及EMG生物反馈训练疗效的研究

目的探讨慢性功能性便秘(CFC)患者肛直肠压力及肌电(EMG)活动特点,同时观察生物反馈训练系统对CFC患者的疗效及对上述指标的影响.方法用BIOLAB动力学参数监测系统(液态式),多道胃肠功能检查仪对144例CFC患者检测,并用OrionPC/12mEMG生物反馈治疗仪进行肌电评估和训练,20例健康者作对照.结果与健康对照组相比,CFC患者肛管静息压稍下降(P＞0.01)、最大缩榨压明显降低(P＜0.01),直肠感知阈和最大耐受量均显著增高(P＜0.01);EMG评估CFC患者盆底肌与腹前斜肌有矛盾运动100%,其运动幅值盆底肌静息状态下升高(P＜0.01)和腹前斜肌降低(P＜0.01);OrionPC/12mEMG生物反馈训练治疗后可显著改善CF C患者上述异常改变(P＜0.01),生物反馈治疗CFC患者临床症状改善,总有效率为84.03%,增加疗程的频次、缩短治疗间隔以及辅助家庭训练等可以提高疗效和降低复发率(P＜0.01).结论CFC患者存在肛门直肠动力、感知觉及肌电活动异常,OrionPC/12mEMG生物反馈系统可以改善上述异常表现,对84.03%的CFC患者具有良好的疗效,较长时间的强化训练可望提高近期疗效,辅助家庭训练可降低复发率.     

功能性便秘的生物反馈治疗

目的评价生物反馈方法治疗功能性便秘的疗效。方法对我院42例慢性功能性便秘患者进行生物反馈治疗,治疗前后进行临床评估、直肠和盆底肌电描记并进行对比分析。结果生物反馈治疗后患者临床症状改善,肌电图显示盆底肌和腹肌的矛盾运动消失,肛门外括约肌的收缩幅度有不同程度的增加,松弛幅度降低(P<0·05),总有效率为93%,改善伴随症状有效率70%,6个月随访复发率仅5·26%。结论生物反馈治疗功能性便秘有效。     

Prospective,randomized trial comparing four biofeedback techniques for patients with constipation

PURPOSE: The aim of this study was to compare four methods of biofeedback for patients with constipation. METHODS: Thirty-six patients were prospectively, randomly assigned to one of four protocols: 1) outpatient intra-anal electromyographic biofeedback training; 2) electromyographic biofeedback training plus intrarectal balloon training; 3) electromyographic biofeedback training plus home training; or 4) electromyographic biofeedback training, balloon training, and home training. All 36 patients received weekly one-hour outpatient biofeedback training. Success was measured by increased unassisted bowel movements and reduction in cathartic use. In all instances patients maintained a daily log in which documentation was maintained regarding each bowel evacuation and the need for any cathartics. RESULTS; There was a statistically significant increase in unassisted bowel movements for Groups 1, 2, and 4 (P<0.05) and a reduction in the use of cathartics in Groups 1, 2, and 3 (P<0.05). CONCLUSION: There was a significant improvement in outcome after all four treatment protocols for constipation; however, no significant difference was found among the treatments. Therefore, electromyographic biofeedback training alone is as effective as with the addition of balloon training, home training, or both.Supported in part by a grant from the Eleanor Naylor Dana Trust Fund.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, San Antonio, Texas, May 2 to 7, 1998.     

生物反馈训练治疗盆底肌痉挛综合症的临床疗效观察

目的探讨生物反馈训练治疗盆底肌痉挛综合症的临床疗效,并对便秘患者进行主观生存质量评价和客观肛门直肠测压检测。 方法将新疆医科大学第一附属医院便秘诊疗门诊收治的诊断明确的盆底肌痉挛综合症患者按患者意愿分为生物反馈训练治疗组和骶神经刺激治疗组,每组患者40例,对两组患者至少随访3个月,并使用生存质量自评表PAC-QOL中文版对入组病人进行生理、社会心理、担忧及满意度四方面进行主观评价和肛门直肠测压的客观评价。 结果主观方面,与骶神经刺激治疗组相比,生物反馈训练治疗可明显改善便秘患者生理、社会心理、担忧及满意度,提高患者生活质量;客观方面,生物反馈训练治疗更能增加直肠感觉阈值,降低肛管静息压和肛管最大收缩压,改善排便困难症状。 结论生物反馈训练治疗可明显改善盆底肌痉挛综合症患者的便秘症状,提高便秘患者的生活质量。     

Comparing the efficacy of biofeedback and balloon-assisted training in the treatment of dyssynergic defecation

BACKGROUND:

Dyssynergic defecation does not respond appropriately to routine treatments for constipation. Recently, research has shown that biofeedback therapy is useful in anorectal dyssynergia.

OBJECTIVE:

To compare two treatment modalities for patients experiencing dyssynergic defecation.

METHODS:

Sixty-five subjects with dyssynergic defecation were recruited and randomly allocated to one of two treatment groups: balloon defecation training and biofeedback therapy. In the first group, a balloon was inserted into the rectum and inflated by water injection so that the patient experienced the sensation of a full rectum and, thus, the need to defecate. The patient was subsequently asked to reject the balloon. In the biofeedback group, the pen electrode of an electromyographic biofeedback device was inserted into the rectum, with the patient subsequently being asked to increase abdominal pressure and relax the rectal muscles accordingly.

RESULTS:

The findings showed a reduction in constipation in both groups. The ability to reject the balloon (volume and time) was significantly better in postintervention measurements; however, better results were found in the biofeedback arm of the study. Patient satisfaction after treatment reached 52% with balloon training and 79% in the biofeedback group. Reports of incomplete evacuation and the need for digit use during defecation remained constant after treatment in balloon-trained patients.

CONCLUSION:

Biofeedback training appeared to be superior to balloon defecation training and resulted in measurable changes in subjective and objective variables of dyssynergia.     

生物反馈训练对功能性便秘患者临床症状、心理状况和生活质量的影响

Objective To explore the effects of biofeedback training on clinical symptom,psychological state and quality of life in patients with functional constipation (FC).Methods Forty-nine patients with FC diagnosed by Rome Ⅲ were enrolled and received biofeedback training Bowel symptom measure, Zung's self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Chinese version of the MOS 36-item short form healthy survey (SF-36) were recorded to assess the effects before and aftertreatment.Results After biofeedback training, clinical symptom of patients with FC was greatly improved:there was a very significant decrease in total and subscales scores of bowel symptom including spontaneous frequency of bowel movements, straining effort, sensation of anorectal obstruction/blockage, stool consistence and bloating.Patients with FC also improved their quality of life as well as psychological status after biofeedback.All subcategories of SF-36 including general health, physical function, bodily pain, role physical, vitality, social function, role emotion and mental health showed marked increase.Compared to the scores before biofeedback training, SAS (41.0 ±8.1 vs 46.5 ± 11.9) and SDS (44.0 ±8.2 vs 51.2 ±11.5) scores decreased significantly after biofeedback training Conclusion Biofeedback training can improve clinical symptom, psychological status and quality of life in patients with FC.     

生物反馈训练对功能性便秘患者临床症状、心理状况和生活质量的影响

Objective To explore the effects of biofeedback training on clinical symptom,psychological state and quality of life in patients with functional constipation (FC).Methods Forty-nine patients with FC diagnosed by Rome Ⅲ were enrolled and received biofeedback training Bowel symptom measure, Zung's self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Chinese version of the MOS 36-item short form healthy survey (SF-36) were recorded to assess the effects before and aftertreatment.Results After biofeedback training, clinical symptom of patients with FC was greatly improved:there was a very significant decrease in total and subscales scores of bowel symptom including spontaneous frequency of bowel movements, straining effort, sensation of anorectal obstruction/blockage, stool consistence and bloating.Patients with FC also improved their quality of life as well as psychological status after biofeedback.All subcategories of SF-36 including general health, physical function, bodily pain, role physical, vitality, social function, role emotion and mental health showed marked increase.Compared to the scores before biofeedback training, SAS (41.0 ±8.1 vs 46.5 ± 11.9) and SDS (44.0 ±8.2 vs 51.2 ±11.5) scores decreased significantly after biofeedback training Conclusion Biofeedback training can improve clinical symptom, psychological status and quality of life in patients with FC.     

Treatment of the spastic pelvic floor syndrome with biofeedback

The spastic pelvic floor syndrome is a functional disorder based on contraction instead of relaxation of the pelvic floor muscle during straining, which inhibits defecation and gives rise to constipation. Until now no adequate treatment has been found for this condition. The treatment described here is aimed at teaching patients to relax their pelvic floor muscle during straining. Treatment consists of a training program with EMG feedback, followed by simulation of the defecation process, using oatmeal porridge. Patients are then given instructions to generalize the relaxation response in their daily lives. Treatment was completely successful in seven of ten patients. The three remaining patients learned to strain in the correct manner, but could not achieve generalization. Two of them underwent subtotal colectomy because of delayed colonic transit times, which subsequently resulted in normal evacuation. In the third patient, the generalization was most likely hampered by psychologic problems, for which she now receives psychotherapy.     

生物反馈训练对功能性便秘患者临床症状、心理状况和生活质量的影响

目的 探讨生物反馈训练对功能性便秘(FC)患者临床症状、心理状况和生活质量的影响.方法 对49例符合FC罗马Ⅲ标准的患者进行生物反馈训练,应用临床症状积分量表、Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉化版简明健康调查量表(SF-36)评定患者治疗前后的临床症状、心理状况和生活质量的综合改善情况.结果 生物反馈训练后,FC患者临床症状显著改善,临床症状积分量表中排便间隔天数、费力程度、排便不尽和坠胀感、粪便性状、腹胀评分及总积分均有显著降低(临床症状改善).SF-36量表的8个维度(总体健康、生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能和精神健康)的评分均显著提高(生活质量改善).患者治疗后与治疗前相比,SAS量表评分(41.0±8.1比46.5±11.9)和SDS量表评分(44.0±8.2比51.2±11.5)亦显著降低(焦虑、抑郁状况改善).结论 生物反馈训练不仅能有效改善FC患者的临床症状,还可提高患者的生活质量和心理健康水平.     

影响慢性心力衰竭患者心脏再同步化治疗效果的因素分析

目的 观察慢性心力衰竭患者心脏再同步化治疗(cardiac resynchronization therapy,CRT)的临床疗效,比较CRT有反应和无反应患者的临床特征,分析不同因素对CRT反应及预后的影响.方法 选取在浙江大学医学院附属第二医院心血管内科成功置入CRT-P/D的慢性心力衰竭患者204例,收集术前临床资料、手术资料及术后随访资料,结合手术前后临床症状及超声心动图参数的改善,评估CRT疗效.比较有反应和无反应患者的临床特征,并通过多因素回归分析及生存分析比较不同因素对CRT反应及预后的影响.结果 纳入研究者共204例,其中男性130例,女性74例,平均年龄(64.8±11.9)岁,随访6～60个月.CRT有反应者125例(61.3％).有反应的患者中,女性、QRS波时限≥150 ms及QRS波形态呈完全性左束支传导阻滞(CLBBB)者所占比例分别为41.6％ (52/125)、58.4％(73/125)、65.6％(82/125),明显高于CRT无反应的患者(P＜0.05).多因素回归分析显示,QRS波时限≥150 ms是CRT有反应的唯一独立预测因子.Kaplan-Meier法分析显示CRT有反应的患者生存率高于无反应的患者(P＜0.001).结论 临床特征,包括女性、QRS波时限≥150 ms及CLBBB,与CRT反应密切相关,其中QRS波时限≥150 ms能独立预测CRT有反应.CRT有反应的患者预后优于无反应的患者.