The Influence On Pelvic Floor SEMG And The Curative Effect Of Obstructive Constipation After Stroke Treated By Acupuncture And Biofeedback

Background: In western countries, stroke is the third lethal disease, and has become second-lethal disease in China. Constipation is a common complication of stroke. The etiology of constipation after stroke is complex so that the disease is difficult treatment. Clinically, constipation after stroke often belongs to outlet obstruction when the treatment is limited to the laxatives.Biofeedback therapy is the first choice of constipation. While in Chinese medicine,acupuncture and moxibustion does better for constipation after stroke.There isn't any observation of the therapy of both in constipation after stroke.Objective: Treat constipation after stroke by acupuncture and biofeedback, and observe pelvic floor surface electromyogram and PAC-QoL before and after the treatment to evaluate the effect.Method: Enrolled 60 cases,who were inpatients or outpatients of Nanjing Hospital of TCM from Sep.2008 to Jan.2010,according to Romeâ…¢process and laboratory examination, were 37 males and 23 females, and 23-82 years old,and had course of disease for 0.5-20 years.In these cases, 43 cases depended on laxatives;17 depended on manual maneuvers. All of them were divided into 3 groups: treatment group and 2 control groups. Treatment group: therapeutic acupoints:BL31,GV20,EX-HN1,BL32,BL33,BL34,BL25,BL23,DU20,BL57,ST25,ST36,SP15,CV4 ,CV6,CV12;biofeedback therapeutic regimen: EMGstim & Kegel training. 10 treatments were a course, and the patients received 1 course of the treatment. PAC-QoL was used as outcome measures to evaluate the therapy. Analyse the relationship between sEMG and final effective.Comparing the curative effect and the quality of life before and after treating.Result: After treating for 1 course, treatment group: 0 case was cured ,1 case was excellent and 12 cases were improved, and the total efficiency was 65%;control group 1 (acupuncture only): 0 case was cured ,2 case was excellent and 8 cases were improved, and the total efficiency was 50%. control group 2 (biofeedback only): 0 case was cured or excellent and 6 cases were improved, and the total efficiency was 30%.The effect of treatment group of control group 2(biofeedback only)has difference(P<0.05),therapy of acupuncture and biofeedback is the best of three groups(P<0,05). PAC-QoL scores of each group has been improved after the therapy(P<0.01), were all reduced obviously(P<0.01). The effect is relevant to the prebaseline, AVGonset, variability of prebaseline, tonic variability and endurance variability of pelvic floor sEMG. There isn't any adverse effect during the study.Conclusion Treating constipation after stroke by acupuncture and biofeedback is effective and security,and can improve the symptoms and life quality, the effect is relevant to the pelvic floor sEMG.