Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
Maternal and Child Health Hospital of Huadu District, Guangzhou, China.
Medicine (Baltimore). 2023 Nov 3;102(44):e35462. doi: 10.1097/MD.0000000000035462.
Patients with functional anorectal pain (FAP) usually feel pain in the anal region, foreign body sensation, and defecation disorders. The pain may radiate to the perineum, thighs, and waist. Conventional biofeedback, local nerve block and surgical treatment have certain limitations. Thread-embedding acupuncture (TEA) is a complementary and alternative therapy, which is widely used in the clinical practice of traditional Chinese medicine to treat functional anorectal pain. This study evaluated the efficacy and safety of the catgut-embedding acupuncture in patients with FAP.
FAP patients were enrolled and randomly divided into a thread-embedding acupuncture group (n = 35) and a sham-embedding acupuncture control group (n = 36). Patients underwent treatment twice monthly for 2 months and were assessed before and after treatments for visual analogue scales (VAS) of anorectal pain, VAS of lumbar pain or soreness, VAS of abdominal distension or pain, anal incontinence index, and SF-36 quality of life. The SF-36 quality of life score included assessment of physical functioning, role-physical, bodily-pain, general health, role-emotional, social functioning, vitality, and mental health.
The total effective rate was 85.71% for the treatment group versus 8.33% of the controls after 2 months (P < .001). The patients' anal rectum VAS score was significantly higher after treatment versus pretreatment (P < .01), while the physical functioning, role-physical, bodily-pain, role-emotional, and mental health in the experimental group and the role-emotional, and mental health in the control group were all significantly improved versus pretreatment (P < .05). The anorectal VAS score, anal incontinence index, and the SF-36 scores of the physical functioning, role-physical, bodily-pain, role-emotional, and mental health were better in the treatment group compared to the control group (P < .05). Most importantly, there were no adverse reactions observed in either group during the treatment.
The thread-embedding acupuncture treatment effectively and safely improved the emotional anxiety and quality of life in FAP patients.
功能性肛门直肠痛（FAP）患者通常在肛门区域感到疼痛、异物感和排便障碍。疼痛可能放射到会阴、大腿和腰部。常规生物反馈、局部神经阻滞和手术治疗有一定的局限性。埋线针刺（TEA）是一种补充和替代疗法，广泛应用于中医临床治疗功能性肛门直肠痛。本研究评估了埋线针刺治疗 FAP 患者的疗效和安全性。
纳入 FAP 患者并随机分为埋线针刺组（n=35）和假埋线针刺对照组（n=36）。患者每月接受两次治疗，共治疗 2 个月，并在治疗前后进行肛门直肠疼痛视觉模拟量表（VAS）、腰痛或酸痛 VAS、腹胀或腹痛 VAS、肛门失禁指数和 SF-36 生活质量评估。SF-36 生活质量评分包括身体功能、角色身体、身体疼痛、总体健康、角色情感、社会功能、活力和心理健康的评估。
治疗 2 个月后，治疗组总有效率为 85.71%，对照组为 8.33%（P<0.001）。治疗后患者肛门直肠 VAS 评分明显高于治疗前（P<0.01），而实验组的身体功能、角色身体、身体疼痛、角色情感和心理健康以及对照组的角色情感和心理健康均明显优于治疗前（P<0.05）。与对照组相比，治疗组的肛门直肠 VAS 评分、肛门失禁指数以及 SF-36 评分中的身体功能、角色身体、身体疼痛、角色情感和心理健康均有改善（P<0.05）。最重要的是，两组在治疗过程中均未观察到不良反应。
埋线针刺治疗可有效、安全地改善 FAP 患者的情绪焦虑和生活质量。
