Digestive System Research Unit, University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Department de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
Digestive System Research Unit, University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Department de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
Clin Gastroenterol Hepatol. 2017 Dec;15(12):1922-1929. doi: 10.1016/j.cgh.2017.06.052. Epub 2017 Jul 11.
BACKGROUND & AIMS: Abdominal distention is produced by abnormal somatic postural tone. We developed an original biofeedback technique based on electromyography-guided control of abdominothoracic muscular activity. We performed a randomized, placebo-controlled study to demonstrate the superiority of biofeedback to placebo for the treatment of abdominal distention.
At a referral center in Spain, we enrolled consecutive patients with visible abdominal distention who fulfilled the Rome III criteria for functional intestinal disorders (47 women, 1 man; 21-74 years old); 2 patients assigned to the placebo group withdrew and 2 patients assigned to biofeedback were not valid for analysis. Abdominothoracic muscle activity was recorded by electromyography. The patients in the biofeedback group were shown the signal and instructed to control muscle activity, whereas patients in the placebo received no instructions and were given oral simethicone. Each patient underwent 3 sessions over a 10-day period. The primary outcomes were subjective sensation of abdominal distention, measured by graphic rating scales for 10 consecutive days before and after the intervention.
Patients in the biofeedback group effectively learned to reduce intercostal activity (by a mean 45% ± 3%), but not patients in the placebo group (reduced by a mean 5% ± 2%; P < .001). Patients in the biofeedback group learned to increase anterior wall muscle activity (by a mean 101% ± 10%), but not in the placebo group (decreased by a mean 4% ± 2%; P < .001). Biofeedback resulted in a 56% ± 1% reduction of abdominal distention (from a mean score of 4.6 ± 0.2 to 2.0 ± 0.2), whereas patients in the placebo group had a reduction of only 13% ± 8% (from a mean score of 4.7 ± 0.1 to 4.1 ± 0.4) (P < .001).
In a randomized trial of patients with a functional intestinal disorder, we found that abdominal distention can be effectively corrected by biofeedback-guided control of abdominothoracic muscular activity, compared with placebo. ClincialTrials.gov no: NCT01205100.
腹部膨胀是由异常躯体姿势引起的。我们开发了一种基于肌电图引导的胸腹肌肉活动控制的原始生物反馈技术。我们进行了一项随机、安慰剂对照研究，以证明生物反馈在治疗腹胀方面优于安慰剂。
在西班牙的一个转诊中心，我们招募了符合罗马 III 功能性肠病标准的连续可见腹胀患者（47 名女性，1 名男性；21-74 岁）；2 名随机分配至安慰剂组的患者退出，2 名随机分配至生物反馈组的患者未进行分析。通过肌电图记录胸腹肌肉活动。生物反馈组的患者观察到信号并被指示控制肌肉活动，而安慰剂组的患者未得到任何指导，并接受口服二甲硅油。每位患者在 10 天内接受 3 次治疗。主要结局是治疗前后 10 天的腹部膨胀主观感觉，通过图形评分量表进行测量。
生物反馈组的患者有效地学会了减少肋间肌活动（平均减少 45%±3%），但安慰剂组的患者没有（平均减少 5%±2%；P<0.001）。生物反馈组的患者学会了增加前壁肌肉活动（平均增加 101%±10%），但安慰剂组的患者没有（平均减少 4%±2%；P<0.001）。生物反馈使腹部膨胀减少了 56%±1%（从平均评分 4.6±0.2 降至 2.0±0.2），而安慰剂组仅减少了 13%±8%（从平均评分 4.7±0.1 降至 4.1±0.4）（P<0.001）。
在一项功能性肠病患者的随机试验中，我们发现与安慰剂相比，通过生物反馈引导的胸腹肌肉活动控制可以有效纠正腹胀。ClinicalTrials.gov 编号：NCT01205100。
