Student Research Committee, School of Rehabiliatation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Arq Gastroenterol. 2024 Jul 19;61:e23146. doi: 10.1590/S0004-2803.24612023-146. eCollection 2024.
Functional constipation (FC) is a common global high prevalence issue in children.
The purpose of the present study is to evaluate the effect of visceral manipulation (VM) on children with chronic interacble FC unresponsive to the standard treatment.
This study was conducted as a randomized, single-blind controlled trial. Fifty-two children with refractory chronic functional constipation unresponsive to the standard medical treatment were randomly allocated to two groups of 26 control (standard medical care (SMC)) and 26 intervention (SMC with VM) for 4 weeks. Abdominal pain, painful defecation, stool consistency, defecation frequency, and the dose of oral laxative were evaluated before and after the treatment period using the Pain Rating Scale, Bristol stool form scale, and patient/parents report.
At the end of treatment, except for the dose of oral laxative in the control group, all of the results showed a significant difference in both groups (P<0.05). The dose of oral laxative in the intervention group decreased significantly (P<0.05), however, no significant change was observed in the control group (P>0.05). In the intervention group comparison, statistically significant differences were found in all va-riables except the Bristol stool form scale (P<0.05). The Bristol stool form scale after treatments was not different when the groups were compared (P=0.32), but the number of subjects who had normal stool consistency was significantly increased in the intervention group than in the control group (P<0.05).
VM can be considered as a possible treatment without side effects besides SMC for the management of chronic FC. Further studies are needed to investigate the long-term effect of VM.
功能性便秘（FC）是全球儿童中一种常见的高患病率问题。
本研究旨在评估内脏推拿（VM）对标准治疗无效的慢性可激发性 FC 儿童的疗效。
本研究为随机、单盲对照试验。52 例对标准药物治疗无反应的难治性慢性功能性便秘儿童随机分为 26 例对照组（标准药物治疗（SMC））和 26 例干预组（SMC 加 VM），治疗 4 周。采用疼痛评分量表、布里斯托大便形状量表和患者/家长报告，分别于治疗前后评估腹痛、排便痛、粪便稠度、排便频率和口服泻药剂量。
治疗结束时，除对照组口服泻药剂量外，两组所有结果均有显著差异（P<0.05）。干预组口服泻药剂量显著减少（P<0.05），而对照组无显著变化（P>0.05）。在干预组比较中，除布里斯托大便形状量表外，所有变量均有统计学差异（P<0.05）。组间比较治疗后布里斯托大便形状量表无差异（P=0.32），但干预组正常粪便稠度的受试者数量明显多于对照组（P<0.05）。
除 SMC 外，VM 可作为慢性 FC 管理的一种可能的治疗方法，无副作用。需要进一步研究来探讨 VM 的长期效果。
