Loening-Baucke V
Department of Pediatrics, University of Iowa, Iowa City 52242.
Gut. 1990 Dec;31(12):1395-402. doi: 10.1136/gut.31.12.1395.
The efficacy of biofeedback treatment on faecal incontinence and anorectal function was evaluated in eight patients with faecal incontinence treated with biofeedback training and medical therapy. Outcome and anorectal function were compared with nine faecal incontinent patients who received medical therapy alone. Three month follow up showed that 50% of patients in the biofeedback plus conventional treatment group and 56% of those treated conventionally only had improved. One year follow up showed that 13% in the biofeedback group were free of soiling and an additional 25% had improved. The results were similar in the conventionally treated group--11% were free of soiling and an additional 44% improved. Anal pressures at rest and squeeze, the rectal distension volume that induced sustained inhibition of both the external and internal anal sphincter, and continence to rectally infused saline were significantly reduced in both groups of patients compared with controls (p less than 0.05). Biofeedback treatment had no effect on these abnormal anorectal functions in either patients who improved or those who did not. The improvement in faecal incontinence was probably due to medical intervention or regression of symptoms with time, or both, and not the result of biofeedback training.
对8例接受生物反馈训练和药物治疗的大便失禁患者,评估了生物反馈治疗对大便失禁及肛门直肠功能的疗效。将结果及肛门直肠功能与9例仅接受药物治疗的大便失禁患者进行比较。3个月的随访显示,生物反馈加传统治疗组50%的患者及仅接受传统治疗组56%的患者病情有所改善。1年的随访显示,生物反馈组13%的患者无便污,另有25%的患者病情改善。传统治疗组的结果相似——11%的患者无便污,另有44%的患者病情改善。与对照组相比,两组患者静息和收缩时的肛门压力、引起肛门外括约肌和内括约肌持续抑制的直肠扩张容积以及对直肠注入盐水的控便能力均显著降低(p<0.05)。生物反馈治疗对病情改善或未改善的患者的这些异常肛门直肠功能均无影响。大便失禁的改善可能是由于药物干预或症状随时间消退,或两者兼而有之,而非生物反馈训练的结果。