呼吸电刺激训练改善膈肌和腹肌功能治疗功能性便秘的作用

目的　观察呼吸电刺激训练对功能性便秘患者的治疗作用。 方法　纳入功能性便秘患者共46例，按随机数字表法分为治疗A组、治疗B组和对照组。A组采用呼吸电刺激和盆底生物反馈治疗联合口服乳果糖治疗，共15例；B组进行盆底生物反馈联合口服乳果糖治疗，共16例；对照组只口服乳果糖治疗，共15例。治疗前和治疗2周后，评估功能性便秘严重程度，并评估膈肌和腹肌增厚率、膈肌活动度。 结果　治疗2周后，各组患者便秘严重程度明显下降（P<0.05），A组膈肌和腹肌增厚率、膈肌活动度较治疗前改善（P<0.05）；与B组及对照组比较，A组便秘严重程度评分明显改善（P<0.05）,膈肌和腹肌增厚率、膈肌活动度改善程度改善明显（P<0.05）。 结论　呼吸电刺激训练可增强盆底生物反馈治疗改善功能性便秘的治疗效果。

Respiratory electrical stimulation training improves diaphragmatic and abdominal muscle function that could treat functional constipation

Objective To use the ultrasound to detect the diaphragm thickening rate, the abdominal muscle thickening rate, and diaphragmatic activity. Constipation scoring system is used to evaluate the curative effect, so as to make clear how does the respiratory electric stimulation training play a part in the functional improvement of diaphragm and abdominal muscle. Methods 46 patients with functional constipation were included in the study for two weeks of treatment. According to the random number, the method is divided into the treatment A group, the treatment B group and the control group. The treatment A group with 15 cases given Lactulose 2 times /day, also underwent pelvic floor muscle biofeedback therapy and respiratory stimulation training 20 minutes each day，3 times/week. In the treatment group B with 16 cases given Lactulose 2 times /day were treated with biofeedback therapy of pelvic floor muscle 20 minutes each day. In the control group, 15 cases were treated with Lactulose 2 times /day. Both at the beginning and end of the treatment, all patients were evaluated by the constipation scoring system, and ultrasonography was used for detection of the diaphragm thickening rate, the abdominal muscle thickening rate, and diaphragmatic activity.　Results　After 2 weeks, in the three groups, the scoring of constipation decreased before treatment (P<0.05). And A group had a score lower than the treatment B group and the control group (P<0.05).The diaphragm thickening rate, the abdominal muscle thickening rate, and the diaphragmatic activity of patients from the treatment of A group were improved than prior to treatment (P<0.05), and there was a statistical difference compared with treatment B group and control group(P<0.05). Conclusion　Respiratory electric stimulation training can effectively improve the contraction strength of the diaphragm and the abdominal muscle, which can enhance the treatment of pelvic floor muscle biofeedback therapy and improve the effect to functional constipation.