| Functional Defecation Disorder(FDD)is a functional disorder characterised by difficulty in defecation,inadequate defecation and the need for finger-assisted defecation,as well as abnormalities in pelvic floor muscle function and inadequate rectal advancement.The physical and mental health of most FDD patients is affected due to the anxiety and depression that associated with FDD.At the same time,they have financial burdens on their families due to the long treatment process.With the improvement of quality of life,people are paying more attention to physical and mental diseases,and the attention to FDD is also increasing.For the time being,the pathogenesis of FDD is still not clearly understood.Although there are many clinical therapies,the efficacy is still not good.Biofeedback therapy is the recommended therapy,but there is less promotion and application of it in China.We found that Sheng-QingJiang-Zhuo-Fang is effective in treating patients with FDD,and has the advantages of being simple and long-lasting.Above all,this study examined the efficacy of Sheng-Qing-Jiang-ZhuoFang in FDD.Objective:To verify the exact therapeutic efficacy of Sheng-Qing-Jiang-Zhuo-Fang for Functional Defecation Disorder with Qi stagnation and spleen deficiency pattern,and to observe its effect on patients’ quality of life and mood.Methods:A totally of 72 patients who visited the Colorectal Department of Dongfang Hospital,Beijing University of Chinese Medicine from July 2022 to February 2023 were randomly assigned to either the experimental group(n=37)or the control group(n=35),The experimental group received Sheng-Qing-Jiang-Zhuo-Fang,while the control group received lactulose,both taken continuously for four weeks.Patients were followed up at the fourth week of treatment by follow-up visits and telephone enquiries.The subjects’ data were collected before treatment,at the fourth week,and at follow-upResults:A totally of 72 patients were enrolled in this trial.There were 37 cases in the experimental group,10 males and 27 females,with a mean age of(53.08 ± 15.25)years and a mean disease-duration of(6.05±2.05)years;35 cases in the control group,9 males and 26 females,with a mean age of(52.03±14.14)years and a mean disease-duration of(5.63±2.06)years.There were no statistically significant differences in baseline demographic and clinical characteristics between the two groups.After treatment,the total efficiency of the trial group was 94.59%and the control group was 71.43%,with statistically significant difference(x2=15.506,P=0.001).The total score of Constipation syndrome in the experimental group(10.3 8 ± 5.47)was lower than that of the control group(16.06±5.10),with a statistically significant difference(P=0.03).There was no meaningful difference between the two groups in terms of stool characteristics、each time to go to the toilet and laborious defecation(P>0.05).The experimental group had significantly lower scores for laborious defecation、feeling of downward/unclean defecation/anal tenesmus and abdominal distension than the control group(P<0.05).Four weeks after the end of treatment,the clinical symptom score of constipation increased in both groups(P<0.001)。Compared with the control group,the experimental group has a lower scores of feeling of downward/unclean defecation/anal tenesmus,stool characteristics,laborious defecation,defecation frequency and each time to go to the toilet,the difference was statistically significant(P<0.05);the score of abdominal distension was lower in the experimental group than in the control group,and the difference was not statistically significant(P>0.05).The total score of traditional Chinese medicine(TCM)syndrome in the experimental group(3.00±1.45)was lower than that of the control group(4.31±1.73),with a statistically significant difference(P=0.03).There was no statistically significant difference between the two groups for the fatigue and gas scores(P>0.05).Four weeks after the end of the treatment,the total score of traditional Chinese medicine(TCM)syndrome of the control group was greater than that of the experimental group(P<0.05)。In terms of the quality of life socre,both groups improved significantly after treatment(P<0.001).The experimental group scores(71.70±8.66)were lower than the control group(77.26±9.52),the difference was not statistically significant(P=0.44).Four weeks after the treatment ended,both groups showed an increase in quality of life scores(P<0.001),and the difference between the two groups was not statistically significant(P>0.05).The SAS score in the experimental group(30.57 ± 5.74)was significantly lower than that of the control group(33.54±3.60),with a statistically significant difference(P=0.009).The SAS scores of patients in both groups increased 4 weeks after the end of treatment(P<0.001),with the experimental group scoring lower than the control group,and the difference was not statistically significant(P>0.05).In SDS scores,SDS scores decreased in both groups compared with the previous one(P<0.001),and SDS scores were lower in the test group(34.54 ± 5.16)than in the control group(36.91± 4.36)after treatment,the difference was not statistically significant(P=0.55).At the time of follow-up,SDS scores increased in both groups(P<0.001),with the experimental group scoring lower than the control group,and the difference was not statistically significant(P>0.05).Conclusion:Sheng-Qing-Jiang-Zhuo-Fang can effectively relieve patients’ symptoms of FDD,improve their quality of life and reduce their anxiety and depression,with better shortterm efficacy than lactulose. |
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