Ashoush Fouad, Abdelrahim Ahmed, Ali Omer, Kamali Dariush, Harrison Sanjay, Reddy Anil, Elshazly Walid, Sultan Mohamed, Saafan Tamer, Abounozha Sabry, Ahmed Mooyad
General Surgery, Northumbria Healthcare NHS Foundation Trust, North Tyneside, GBR.
General Surgery, Health Education England North East, Newcastle, GBR.
Cureus. 2025 Mar 20;17(3):e80885. doi: 10.7759/cureus.80885. eCollection 2025 Mar.
Introduction Obstructed defecation syndrome (ODS) is a common disorder in developed countries. This study aims to compare the efficacy of bilateral percutaneous tibial nerve stimulation (Bi-PTNS) to biofeedback therapy (BFT) in adult patients with ODS. Methods A prospective randomised control study was conducted on patients aged ≥18 years, diagnosed with ODS, who were referred to the Colorectal Surgery Department at a main university hospital between 2018 and 2020. Computerized 1:1 block randomization allocated patients into two groups: the bi-PTNS group and the BFT group. The Constipation Scoring System and Patient Assessment of Constipation Quality of Life Score (PAC-QoL) were used to assess the severity of the patient's symptoms prior to and after treatment. The primary outcome was the improvement of the Constipation Scoring System. The secondary outcome was the PAC-QoL score. Results In total, 60 patients, with 38 females (mean of 43 years in the BFT group and 48 years in the Bi-PTNS group), were studied. Statistically significant differences were achieved in patients who underwent bi-PTNS compared to the BFT group (p < 0.001). The average improvement in the Constipation Scoring System score for the bi-PTNS group was 66.66% ± 8.44 compared to 47.36% ± 10.44 for the BFT group. The bi-PTNS group showed improvement in the PAC-QoL score (60.41% ± 4.03) compared with 42.59% ±6.25 in the BFT group. Conclusion The Bi-PTNS intervention was more effective than BFT in alleviating symptoms of OD compared to BFT, evidenced by improvements in both the Constipation Scoring System and PAC-QoL scores.
引言
排便障碍综合征(ODS)在发达国家是一种常见疾病。本研究旨在比较双侧经皮胫神经刺激(Bi-PTNS)与生物反馈疗法(BFT)对成年ODS患者的疗效。
方法
对2018年至2020年间转诊至某主要大学医院结直肠外科的年龄≥18岁、诊断为ODS的患者进行了一项前瞻性随机对照研究。通过计算机1:1区组随机化将患者分为两组:Bi-PTNS组和BFT组。采用便秘评分系统和便秘生活质量患者评估量表(PAC-QoL)评估患者治疗前后症状的严重程度。主要结局是便秘评分系统的改善情况。次要结局是PAC-QoL评分。
结果
总共研究了60例患者,其中女性38例(BFT组平均年龄43岁,Bi-PTNS组平均年龄48岁)。与BFT组相比,接受Bi-PTNS治疗的患者有统计学显著差异(p<0.001)。Bi-PTNS组便秘评分系统评分的平均改善率为66.66%±8.44,而BFT组为47.36%±10.44。Bi-PTNS组的PAC-QoL评分有所改善(60.41%±4.03),而BFT组为42.59%±6.25。
结论
与BFT相比,Bi-PTNS干预在缓解OD症状方面比BFT更有效,这在便秘评分系统和PAC-QoL评分的改善中得到了证明。