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粪便失禁患者的盆底肌训练与注意力控制按摩治疗对比:一项随机对照试验的统计分析计划

Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence: Statistical analysis plan for a randomised controlled trial.

作者信息

Ussing Anja, Dahn Inge, Due Ulla, Sørensen Michael, Petersen Janne, Bandholm Thomas

机构信息

Department of Physiotherapy-and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Kettegaards Allé 30, DK-2650 Hvidovre, Denmark.

Optimed, Clinical Research Center, Copenhagen University Hospital, Hvidovre, Kettegaards Allé 30, DK-2650 Hvidovre, Denmark.

出版信息

Contemp Clin Trials Commun. 2017 Jul 22;8:192-202. doi: 10.1016/j.conctc.2017.07.006. eCollection 2017 Dec.

Abstract

INTRODUCTION

Faecal incontinence affects approximately 8-9% of the adult population. The condition is surrounded by taboo; it can have a devastating impact on quality of life and lead to major limitations in daily life. Pelvic floor muscle training in combination with information and fibre supplements is recommended as first-line treatment for faecal incontinence. Despite this, the effect of pelvic floor muscle training for faecal incontinence is unclear. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment and compared this to an attention-control massage treatment including conservative treatment. The aim of this trial is to investigate if 16 weeks of supervised pelvic floor muscle training in combination with conservative treatment is superior to attention-control massage treatment and conservative treatment in patients with faecal incontinence.

DESIGN

Randomised, controlled, superiority trial with two parallel arms.

METHODS

100 participants with faecal incontinence will be randomised to either (1) individually supervised pelvic floor muscle training and conservative treatment or (2) attention-control massage treatment and conservative treatment. The primary outcome is participants' rating of symptom changes after 16 weeks of treatment using the Patient Global Impression of Improvement Scale. Secondary outcomes are the Vaizey Incontinence Score, the Fecal Incontinence Severity Index, the Fecal Incontinence Quality of Life Scale, a 14-day bowel diary, anorectal manometry and rectal capacity measurements. Follow-up assessment at 36 months will be conducted.

DISCUSSION

This paper describes and discusses the rationale, the methods and in particular the statistical analysis plan of this trial.

摘要

引言

大便失禁影响约8-9%的成年人口。这种情况存在诸多禁忌;它会对生活质量产生毁灭性影响,并导致日常生活中的重大限制。盆底肌肉训练结合信息和纤维补充剂被推荐为大便失禁的一线治疗方法。尽管如此,盆底肌肉训练对大便失禁的效果尚不清楚。此前尚无试验研究过有监督的盆底肌肉训练与保守治疗相结合的疗效,并将其与包括保守治疗在内的注意力控制按摩治疗进行比较。本试验的目的是研究在大便失禁患者中,16周有监督的盆底肌肉训练结合保守治疗是否优于注意力控制按摩治疗和保守治疗。

设计

随机、对照、优效性试验,有两个平行组。

方法

100名大便失禁参与者将被随机分为两组,一组接受(1)个体化监督的盆底肌肉训练和保守治疗,另一组接受(2)注意力控制按摩治疗和保守治疗。主要结局是使用患者总体改善印象量表对治疗16周后症状变化的评分。次要结局包括韦齐失禁评分、大便失禁严重程度指数、大便失禁生活质量量表、14天排便日记、肛门直肠测压和直肠容量测量。将在36个月时进行随访评估。

讨论

本文描述并讨论了该试验的基本原理、方法,特别是统计分析计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac2c/5898528/2691cc7451d8/gr1.jpg

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