Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
Pelvic Floor Medicine Specialty Committee of World Federation of Chinese Medicine Societies, Nanjing, China.
Turk J Gastroenterol. 2024 Feb;35(2):83-91. doi: 10.5152/tjg.2024.22516.
BACKGROUND/AIMS: Functional anorectal pain is one of several types of functional anorectal disorders. In this study, we compared the effectiveness of acupuncture (intervention) and biofeedback (control) as treatment for patients with functional anorectal pain.
This prospective, single-center, randomized, and comparative study examined 68 patients with functional anorectal pain who were recruited from June 2017 to January 2019 at the Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine. Patients were randomly assigned to receive acupuncture or biofeedback. Patients in the acupuncture group received acupuncture at Zhongliao (BL33), Xialiao (BL34), Ganshu (BL18), Shenshu (BL23), and Dachangshu (BL25). Patients in the biofeedback group received pelvic floor biofeedback therapy, consisting of Kegel pelvic floor muscle training and electrical stimulation. Patients in both groups received 20 treatments over 4 weeks. The primary outcome was pain score on a visual analog scale, and the secondary outcomes were results from the MOS 36-item short-form health survey (SF-36) quality of life questionnaire, the self-rating depression scale, and the self-rating anxiety scale.
Visual analog scale pain scores significantly decreased in both of the groups with treatment (both P < .01). The final visual analog scale score was significantly lower in patients with pelvic floor dyssynergia who were treated with biofeedback (1.40 ± 0.97 vs. 5.30 ± 1.70) (P < .05). The 2 groups had similar decreases in self-rating depression scale and self-rating anxiety scale scores. Intriguingly, the acupuncture group had better mental health outcomes (P <.05).
Both acupuncture and biofeedback therapy reduced the pain of patients with functional anorectal pain. Biofeedback provided more relief in patients with pelvic floor dyssynergia, and acupuncture provided greater improvements in mental health status.
背景/目的：功能性肛门直肠痛是几种功能性肛门直肠疾病之一。在这项研究中，我们比较了针刺（干预）和生物反馈（对照）作为治疗功能性肛门直肠痛患者的疗效。
这项前瞻性、单中心、随机、对照研究共纳入了 2017 年 6 月至 2019 年 1 月期间在南京中医药大学附属南京中医院就诊的 68 例功能性肛门直肠痛患者。患者被随机分为针刺组和生物反馈组。针刺组患者接受针刺中髎（BL33）、下髎（BL34）、肝俞（BL18）、肾俞（BL23）和大肠俞（BL25）治疗。生物反馈组患者接受盆底生物反馈治疗，包括凯格尔盆底肌肉训练和电刺激。两组患者均接受 4 周 20 次治疗。主要结局指标为视觉模拟评分法（VAS）疼痛评分，次要结局指标为 MOS 36 项简短健康调查问卷（SF-36）生活质量问卷、自评抑郁量表和自评焦虑量表的结果。
两组患者治疗后 VAS 疼痛评分均显著降低（均 P <.01）。盆底协同失调患者接受生物反馈治疗后的最终 VAS 评分明显较低（1.40 ± 0.97 比 5.30 ± 1.70）（P <.05）。两组患者的自评抑郁量表和自评焦虑量表评分均有类似的下降。有趣的是，针刺组的心理健康状况改善更明显（P <.05）。
针刺和生物反馈治疗均能减轻功能性肛门直肠痛患者的疼痛。生物反馈在盆底协同失调患者中提供了更多的缓解，而针刺在改善心理健康方面提供了更大的改善。
