van Ginkel R, Benninga M A, Blommaart P J, van der Plas R N, Boeckxstaens G E, Büller H A, Taminiau J A
Division of Pediatric Gastroenterology and Nutrition, the Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
J Pediatr. 2000 Dec;137(6):808-13. doi: 10.1067/mpd.2000.109153.
To determine whether the combination of laxative treatment and biofeedback therapy (BF) is more effective for management of functional nonretentive fecal soiling than biofeedback therapy alone.
In a prospective nonblinded study, 48 children were randomized in 2 groups: treatment with oral laxatives (LAX) and 5 sessions of BF (BF + LAX) or 5 sessions of BF alone (BF) during a treatment intervention period of 7 weeks. Biofeedback was performed with perfused manometry catheters and rectal balloon distension. Training focused on awareness of balloon distension and instruction in correct defecation dynamics. Successful treatment was defined as <1 encopresis episode per 2 weeks.
At the end of the intervention period, the number of encopresis episodes was significantly decreased in both groups: from 7 (2 to 24) to 2 (0 to 17) in the BF group and from 7 (3 to 25) to 2 (0 to 14) in the BF + LAX group. However, children given BF alone had significantly higher success rates than children treated with BF and additional oral laxatives (44% to 11%).
There is no additional effect of laxative treatment in functional nonretentive fecal soiling. Children treated with BF in combination with laxatives showed a significantly lower success percentage compared with those treated with BF alone. These results suggest that children with functional nonretentive fecal soiling should be treated differently from children with constipation and encopresis.
确定缓泻剂治疗与生物反馈疗法（BF）联合使用在功能性非潴留性大便失禁管理中是否比单纯生物反馈疗法更有效。
在一项前瞻性非盲研究中，48名儿童被随机分为两组：在为期7周的治疗干预期内，一组接受口服缓泻剂（LAX）和5次生物反馈治疗（BF + LAX），另一组仅接受5次生物反馈治疗（BF）。使用灌注测压导管和直肠气囊扩张进行生物反馈治疗。训练重点是对气囊扩张的感知以及正确排便动力学的指导。成功治疗定义为每2周排便失禁发作少于1次。
在干预期结束时，两组的排便失禁发作次数均显著减少：BF组从7次（2至24次）降至2次（0至17次），BF + LAX组从7次（3至25次）降至2次（0至14次）。然而，单纯接受生物反馈治疗的儿童成功率显著高于接受生物反馈治疗并额外使用口服缓泻剂的儿童（44%对11%）。
缓泻剂治疗对功能性非潴留性大便失禁没有额外效果。与单纯接受生物反馈治疗的儿童相比，联合使用缓泻剂进行生物反馈治疗的儿童成功率显著更低。这些结果表明，功能性非潴留性大便失禁儿童的治疗方式应与便秘和排便失禁儿童有所不同。
