Acupuncture Versus Biofeedback for Treatment of Functional Anorectal Pain
Acupuncture Versus Biofeedback for Treatment of Functional Anorectal Pain
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针灸与生物反馈治疗功能性肛门直肠疼痛
DOI：
10.5152/tjg.2024.22516
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Yijiang Ding
中科院分区：
文献类型：
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作者：
Yahong Xue;Shuqing Ding;Hui;Min Li;Jianbao Cao;Qian Chen;Yijiang Ding
背景/目的：功能性肛门直肠疼痛是功能性肛门直肠疾病的几种类型之一。在这项研究中，我们比较了针灸（干预）和生物反馈（控制）作为功能性肛门直肠疼痛患者治疗的有效性。材料与方法：这项前瞻性、单中心、随机和比较研究检查了2017年6月至2019年1月在南京中医药大学附属南京中医院招募的68例功能性肛门直肠疼痛患者。患者被随机分配接受针灸或生物反馈。针刺组针刺中辽、下辽、肝俞、肾俞、大肠俞。生物反馈组患者接受盆底生物反馈治疗，包括Kegel盆底肌肉训练和电刺激。两组患者在4周内接受了20次治疗。主要结局是视觉模拟量表上的疼痛评分，次要结局是MOS 36项简式健康调查（SF-36）生活质量问卷、抑郁自评量表和焦虑自评量表的结果。结果：两组治疗后视觉模拟量表疼痛评分均显著降低（均P <0.01）。生物反馈治疗组的最终视觉模拟量表评分显著低于对照组（1.40 ± 0.97 vs. 5.30 ± 1.70）（P <0.05）。两组患者抑郁自评量表和焦虑自评量表评分下降幅度相似。有趣的是，针灸组有更好的心理健康结果（P <0.05）。结论：针刺与生物反馈疗法均能减轻功能性肛肠痛患者的疼痛。生物反馈提供了更多的缓解患者的盆底失调，针灸提供了更大的改善心理健康状况。
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. Materials and Methods: 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. Results: 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). Conclusion: 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.