目的 探讨八段锦联合生物反馈干预功能性排便障碍(FDD)的临床疗效及对血清脑肠肽的影响。方法 2017年6月至2018年2月,按随机数字表法将FDD患者68例分成对照组(n=34)和观察组(n=34)。两组均接受生物反馈疗法,观察组在生物反馈基础上接受八段锦功法锻炼,共12周。对两组临床总疗效,以及干预前后便秘主症积分、便秘患者生存质量问卷(PAC-QOL)和血清脑肠肽进行分析比较。结果 剔除脱落病例,观察组总疗效优于对照组(Z=-2.065, P=0.039)。干预后,两组便秘主症积分均改善(t>2.162, P<0.05),观察组干预后排便不尽感、排便时间、腹胀积分明显低于对照组(t>2.837, P<0.01),排便费力程度积分也低于对照组(t=-2.070, P<0.05);两组PAC-QOL积分均降低(t>2.085, P<0.05),观察组低于对照组(t=-2.243, P<0.05);两组血清5-羟色胺(5-HT)、一氧化氮(NO)、血管活性肽(VIP)均明显降低(t>2.420, P<0.05),血清P物质(SP)显著增高(t>6.780, P<0.001),观察组血清5-HT、NO、VIP均低于对照组(t>2.039, P<0.05),SP显著高于对照组(t=3.500, P<0.001)。结论 八段锦联合生物反馈可改善FDD患者临床疗效,其机制与调控脑肠肽的异常分泌和表达密切相关。
Objective To investigate the clinical efficacy of Baduanjin combined with biofeedback on functional defecation disorders and the effect on serum brain-gut peptide.Methods From June, 2017 to February, 2018, 68 patients were randomly divided into control group (n=34) and observation group (n=34). Both groups received biofeedback therapy, and the observation group took the training of Baduanjin in addition, for twelve weeks. Then, their overall clinical efficacy, main syndrome score of constipation, the score of Patient Assessment of Constipation Quality of Life (PAC-QOL) and Brain-gut peptide level were compared before and after intervention.Results The total clinical efficacy was higher in the observation group than in the control group (Z=-2.065, P=0.039) without shedding cases. After treatment, the main symptoms of constipation significantly improved (t>2.162, P<0.05) in both groups, while the defecation inactivity, defecation time and abdominal distension score were significantly lower in the observation group than in the control group (t>2.837, P<0.01), as well as the defecation strain (t=-2.070, P<0.05); the score of PAC-QOL decreased (t>2.085, P<0.05) in both groups, and was lower (t=-2.243, P<0.05) in the observation group than in the control group; the level of serum 5-hydroxytryptamine (5-HT), nitric oxide (NO) and vasoactive intestinal peptide (VIP) decreased (t>2.420, P<0.05), while the level of serum substance P (SP) increased (t>6.780, P<0.001), the level of serum 5-HT, serum NO and serum VIP was lower (t>2.039, P<0.05), and the level of serum SP was higher (t=3.500, P<0.001) in the observation group than in the control group.Conclusion Baduanjin combined with biofeedback can improve the clinical efficacy of patients with functional defecation disorders, and its mechanism is closely related to the regulation of abnormal secretion and the expression of brain-gut peptide.
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