The Observation Of Curative Effect Of Acupuncture Combined Biofeedback Therapy Treating Constipation After Ischemic Stroke

Background:Stroke is a kind of commom disease that affecting the patient’s motor function of limbs,the quality of life and life span. Stroke is the second fatal disease of China. As a common symptom, constipation can affect their health and quality of life of patients.Patients after stroke are more likely to have constipation,in turn,constipation seriously affect the quality of life of stroke patients and their recovering from stroke.Surveys show that outlet obstructive constipation(OOC) is the major part of all kinds of constipations happended after ischemic stroke. Biofeedback technique is a internationally recognized treatment to OOC.Acupuncture and moxibustion are effective to constipation after stroke.However, acupuncture combined biofeedback therapy treating constipation after ischemic stroke still need further research.Objective:To explore the therapeutic effects of acupuncture combined biofeedback therapy treating OOC after ischemic stroke,and to judge the effectiveness and safety of this therapy by observing the changing of PAC-QoL,CSS and pelvic floor surface electromyography(EMG).Method:Enrolled 40 cases who were inpatients or outpatients of Nanjing Hospital of TCM from Mar.2015 to Jan.2016.There are 20 Males and 20 females,and 50-79 years old,and had course of disease for 0.25-20 years.They were randomly divided into treatment group(acupuncture and biofeedback) and medicine control group (lactulose),20 cases of each group.Treatment group:acupuncture and moxibustion therapy 30min, EMG stim 30min and Kegel training 15-30min,5 times a week.Medicine control group(lactulose):25ml,po,Qd. All categories are 10 treatments in a course,after 2 courses we evaluate the therapy and follow-up a month. PAC-QoL,CSS and pelvic floor electromyography are used as outcome measures to evaluate the therapy.Result:After two courses of treatment, PAC-QoL and CSS have significant differences (P < 0.01) between before and after treatment in the both therapy group and control group. PAC-QoL and CSS after therapy between the two groups have no significant difference (P> 0.05).EMG:①hefore baseline:have significant differences(P<0.01) between before and after treatment in the therapy group, have no significant difference (P>0.05) between before and after treatment in the control group, have no significant difference between the two groups after therapy.②The variability of before baseline:have differences (P<0.05) between before and after treatment in the therapy group, have no significant difference (P>0.05) between before and after treatment in the control group, have no significant difference (P>0.05) between the two groups after therapy. ③The variability of continuous contraction:have significant differences (P< 0.01) between before and after treatment in the therapy group, have no significant difference (P>0.05) between before and after treatment in the control group, have significant difference (P<0.05) between the two groups after therapy.④The variability of sustained contraction:have significant differences (P< 0.01) between before and after treatment in the therapy group, have no significant difference (P>0.05) between before and after treatment in the control group, have no significant difference (P>0.05) between the two groups after therapy.1 month follow-up showed that the therapy group and control group did not experience diminished effectiveness or safety problems.Conclusion:Both the therapy group and control group have similarly significant improvements in PAC-QoL and CSS. The therapy group has more significant improvements in EMG than control group.Accordingly, acupuncture combined biofeedback therapy treating OOC after ischemic stroke is effective on the improvement of symptoms,and the improvement of function of pelvic floor muscles.Besides,the therapy is safe and difficult to recur.