经皮胫神经刺激治疗功能性便秘。
Transcutaneous Tibial Nerve Stimulation as Therapy for Functional Constipation.
机构信息
Department of General Surgery, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey.
Department of Gastroenterology, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkey.
出版信息
Turk J Gastroenterol. 2022 Jul;33(7):565-569. doi: 10.5152/tjg.2022.21342.
BACKGROUND
Functional constipation is a common disorder that is difficult to treat on occasion. Symptoms of this condition can per- sist despite dietary modification, exercise, and medication. Results of neuromodulation with nerve stimulation have been promising in terms of efficiency for treatment-resistant patients. This study aimed to investigate the efficacy of bilateral transcutaneous tibial nerve stimulation as a noninvasive treatment method for functional constipation.
METHODS
We evaluated 105 patients with functional constipation diagnosed using the Rome IV criteria. Bilateral transcutaneous elec- trical nerve stimulation was utilized for transcutaneous tibial nerve stimulation for 6 weeks; 3 sessions were conducted every week, with each session lasting for at least 30 minutes. The Constipation Severity Instrument was used before treatment, at the end of 6 weeks, and at 12 weeks (6 weeks after the end of treatment). The effects of transcutaneous tibial nerve stimulation on the time spent in the toilet and the use of softeners were investigated.
RESULTS
Of the 105 patients included in the study, 41 (39%) were male. The mean age was 43.1 (range, 19-64 years). Transcutaneous tibial nerve stimulation was found to reduce the time patients spent in the toilet. The use of softeners decreased from 76.2% to 20% (P < .001). Obstructive defecation (P < .001), colonic inertia (P < .001), pain (P < .001), and Constipation Severity Instrument total score (P < .001) improved after the 6-week treatment period. The treatment effect persisted until the 12th week.
CONCLUSION
Bilateral transcutaneous tibial nerve stimulation is a noninvasive, easily applicable, and effective treatment for functional constipation, without major adverse effects. Large randomized controlled trials are required so that transcutaneous tibial nerve stimula- tion can be established as an alternative treatment for functional constipation that is resistant to standard care and laxative agents.
背景
功能性便秘是一种常见的疾病，有时难以治疗。尽管进行了饮食调整、运动和药物治疗，这种疾病的症状仍可能持续存在。神经刺激的神经调节在治疗抵抗患者方面的效果令人鼓舞。本研究旨在探讨双侧经皮胫神经刺激作为一种非侵入性治疗方法治疗功能性便秘的疗效。
方法
我们评估了 105 例符合罗马 IV 标准的功能性便秘患者。双侧经皮电神经刺激用于经皮胫神经刺激，共 6 周；每周进行 3 次治疗，每次至少 30 分钟。在治疗前、6 周结束时和 12 周（治疗结束后 6 周）使用便秘严重程度量表进行评估。研究了经皮胫神经刺激对患者在厕所花费的时间和使用软化剂的影响。
结果
在纳入研究的 105 例患者中，41 例（39%）为男性。平均年龄为 43.1 岁（范围为 19-64 岁）。经皮胫神经刺激可减少患者在厕所花费的时间。软化剂的使用从 76.2%下降到 20%（P <.001）。梗阻性排便（P <.001）、结肠惰性（P <.001）、疼痛（P <.001）和便秘严重程度量表总分（P <.001）在 6 周治疗后均得到改善。治疗效果持续到第 12 周。
结论
双侧经皮胫神经刺激是一种非侵入性、易于应用且有效的功能性便秘治疗方法，无明显不良反应。需要进行大规模随机对照试验，以便经皮胫神经刺激可以作为对标准治疗和泻药抵抗的功能性便秘的替代治疗方法。
Zotero 插件