Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia
Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia
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DOI：
10.1053/j.gastro.2005.11.014
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发表时间：
2006-03-01
期刊：
影响因子：
29.4
通讯作者：
Bassotti, G
中科院分区：
文献类型：
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作者：
Chiarioni, G;Whitehead, WE;Bassotti, G
背景与目的：非对照试验表明，生物反馈是治疗盆底协同失调(PFD)的有效方法，PFD是一种便秘，其特征是排便时盆底肌肉出现矛盾收缩或无法放松。其目的是将生物反馈与泻药加教育进行比较。方法：对慢性重度PFD患者首先给予20g/d的纤维灌肠或栓剂灌肠，每周2次。无效者随机接受每周5次生物反馈治疗(n=54)或聚乙二醇14.6-29.2g/d加每周5次咨询治疗以预防便秘(n=55)。在6个月和12个月后对治疗满意度、便秘症状和盆底生理进行评估。生物反馈组在24个月时也进行了评估。泻药治疗的患者在6个月后被指示将聚乙二醇剂量从14.6g/d增加到29.2g/d。结果：在6个月时，接受生物反馈治疗的54例患者中有43例(80%)明显改善，而接受泻药治疗的55例患者中有12例(22%)有明显改善(P
Background & Aims: Uncontrolled trials suggest biofeedback is an effective treatment for pelvic floor dyssynergia (PFD), a type of constipation defined by paradoxical contraction, or inability to relax, pelvic floor muscles during defecation. The aim was to compare biofeedback to laxatives plus education. Methods: Patients with chronic, severe PFD were first treated with 20 g/day fiber plus enemas or suppositories up to twice weekly. Nonresponders were randomized to either 5 weekly biofeedback sessions (n = 54) or polyethylene glycol 14.6-29.2 g/day plus 5 weekly counseling sessions in preventing constipation (n = 55). Satisfaction with treatment, symptoms of constipation, and pelvic floor physiology were assessed 6 and 12 months later. The biofeedback group was also assessed at 24 months. Laxative-treated patients were instructed to increase the dose of polyethylene glycol from 14.6 to 29.2 g/day after 6 months. Results: At 6 months, major improvement was reported by 43 of 54 (80%) biofeedback patients vs 12 of 55 (22%) laxative-treated patients (P