Mibu Ryuichi, Hotokezaka Masayuki, Mihara Shouichi, Tanaka Masao
Department of Surgery, School of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Dis Colon Rectum. 2003 Oct;46(10 Suppl):S50-3. doi: 10.1097/01.DCR.0000083443.18111.A6.
Electrogalvanic stimulation and biofeedback therapy for the treatment of intractable anorectal pain have been reported. However, these therapeutic modalities have some disadvantages and insufficient effectiveness. We noticed that digital examination revealed the strongly tender point in both lateral sides of the rectum and introduced linearly polarized near-infrared irradiation therapy to the strongly tender point. The purpose of this study was to review the outcomes and estimate its usefulness.
A total of 35 consecutive patients complained of vague and deep pain in the anorectum. Fourteen patients had a history of lower abdominal surgery. Eighteen patients had disordered defecation. The linearly polarized near-infrared light was irradiated to the strongly tender point on or a few centimeters apart from the skin for ten minutes. The effect of the therapy was assessed as excellent, good, no change, or worse by the patients themselves.
Ten patients had the strongly tender point in the left side, 8 in the right posterior, and 17 in both. Five patients estimated as excellent, 28 as good, and 2 as no change. Mean total number of irradiation was 18.8 (range, 1-235), and mean number of irradiation for relief from pain was 2.5 (range, 1-9). Anorectal pain recurred in four patients, who received the same therapy and improved. Four patients felt hot during the irradiation, and a patient had frequent micturition after the irradiation. These mild complications easily disappeared.
The linearly polarized near-infrared irradiation therapy is a simple, safe, and effective modality for relief from intractable anorectal pain and recommended for primary therapy.
已有关于采用电刺激和生物反馈疗法治疗顽固性肛肠疼痛的报道。然而，这些治疗方式存在一些缺点且疗效欠佳。我们注意到指诊时在直肠两侧均发现有明显压痛点，并对这些明显压痛点采用了线性偏振近红外照射疗法。本研究的目的是回顾其治疗结果并评估其有效性。
连续纳入35例主诉肛肠部位有模糊深部疼痛的患者。14例患者有下腹部手术史。18例患者存在排便紊乱。将线性偏振近红外光照射至距皮肤表面1厘米处或几厘米处的明显压痛点，持续照射10分钟。由患者自行评估治疗效果为优、良、无变化或恶化。
10例患者的明显压痛点在左侧，8例在右后方，17例两侧均有。5例患者评估为优，28例为良，2例无变化。平均总照射次数为18.8次（范围1 - 235次），疼痛缓解的平均照射次数为2.5次（范围1 - 9次）。4例患者肛肠疼痛复发，再次接受相同治疗后好转。4例患者在照射过程中感觉发热，1例患者照射后出现尿频。这些轻微并发症很容易消失。
线性偏振近红外照射疗法是一种简单、安全且有效的缓解顽固性肛肠疼痛的方法，推荐作为首选治疗方法。
