Li Miaomiao, Ye Bixing, Tang Yurong, Wang Meifeng, Tian Yuan, Zhang Hongjie, Li Xueliang, Lin Lin
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Jan;53(1):40-3.
To explore the anorectal physiology, psychological state, quality of life, lifestyle of patients with chronic constipation (CC) and evaluate the factors which potentially predict the efficacy of biofeedback therapy (BF).
Seventy CC patients receiving BF training were enrolled in this study. Anorectal physiology, Zung's Self-Rating Depression Scale (SDS), Zung's Self-Rating Anxiety Scale (SAS) and Chinese version of the MOS 36-item short form healthy survey (SF-36), lifestyle scale were recorded before BF training. A bowel symptom measurement including five major symptoms was recorded before and after BF training. The improvement in the symptom score was considered as criteria of clinical efficacy of BF therapy. Thirty-two possible influencing factors of efficacy of BF therapy were selected. Univariate analysis and multivariate analysis were conducted to assess the independent predictors.
The results of univariate analysis showed that efficacy of BF therapy was positively correlated to the role physical (r = 0.256, P = 0.031), negatively correlated to the score of SDS (r = -0.315, P = 0.007) and the first sensation threshold (r = -0.278, P = 0.020). The multivariate analysis showed the score of SDS (β = -0.263, P = 0.033) and the first sensation volume (β = -0.281, P = 0.013) were the independent predicator of efficacy of BF therapy.
CC patients who tended to depression state and rectal hyposensitivity have poor response to BF therapy. To treat these patients purposely could optimize the efficacy of BF therapy.
探讨慢性便秘（CC）患者的肛肠生理、心理状态、生活质量、生活方式，并评估可能预测生物反馈疗法（BF）疗效的因素。
本研究纳入70例接受BF训练的CC患者。在BF训练前记录肛肠生理、zung氏自评抑郁量表（SDS）、zung氏自评焦虑量表（SAS）和中文版MOS 36项简短健康调查（SF-36）、生活方式量表。在BF训练前后记录包括五种主要症状的肠道症状测量。症状评分的改善被视为BF治疗临床疗效的标准。选择32个可能影响BF治疗疗效的因素。进行单因素分析和多因素分析以评估独立预测因素。
单因素分析结果显示，BF治疗疗效与生理功能（r = 0.256，P = 0.031）呈正相关，与SDS评分（r = -0.315，P = 0.007）和首次感觉阈值（r = -0.278，P = 0.020）呈负相关。多因素分析显示，SDS评分（β = -0.263，P = 0.033）和首次感觉量（β = -0.281，P = 0.013）是BF治疗疗效的独立预测因素。
倾向于抑郁状态和直肠感觉减退的CC患者对BF治疗反应较差。针对性地治疗这些患者可以优化BF治疗的疗效。
