Efficacy Of Biofeedback Combined With Psychotherapy In The Treatment Of Functional Constipation

Objective:To investigate the change of FC patients with two treatments(biofeedback therapy, biofeedback therapy combined with psychological treatment) treatment before and after the SAS, SDS, efficiency, symptom scores, anorectal manometry indexes, 72 hours colon excretion rate(grain) changes), and explore whether there are differences in the two treatment methods for the efficacy of FC treatment.Methods:Screening clinic and ward patients 70 cases in gastroenterology department of our hospital from 2015 February to 2015 October, which were randomly assigned to two groups, the experimental group of 35 cases were treated by biofeedback combined with psychological treatment, 35 cases in the control group were treated by biological feedback therapy, the two groups of patients with treatment prior to age, gender, disease duration, SAS, SDS and symptom scores, anal manometry, 72 hours colon excretion rate(grain) differences were not significant(P > 0.05).Biofeedback therapy: each treatment 40min-1h, first weeks 1 times 1 days, second weeks to start the 1 /2-3 days, 15 times per course of treatment.Mental therapy: psychological counseling, social support, cognitive behavior therapy, daily use of anti anxiety and depression drugs before biofeedback therapy.Results:After treatment,Control group: 8 cases were cured, 15 cases markedly effective, effective in 8 cases, 4 cases invalid,SAS for 36.8 ±11.2 and SDS for 41.6 + 10.8, symptom score was 5.20± 2.04, initial perception threshold(ML) 35.43 ± 17.39, maximum tolerated volume(ML) was 100.21 ± 16.82, defecation urgency sense threshold(ML) 103.60 ± 25.37 and 72 hours colon excretion rate(%) was 66.5 ± 15.4, 72 hours colon discharge grain 13.5 ±3.5, pelvic floor muscle abnormal contraction rate was 17.14, rectal compliance(ml/mm Hg) is 4.45± 0.94.Experimental group: the clinical cure in 10 cases, markedly effective in 14 cases, 9 cases were effective, 2 cases ineffective,SAS for 32.4±10.5, SDS 40.9±11.4, symptom scores for 4.32±2.03, Initial sensory threshold(ML) 32.84 ±18.96,the maximum tolerated volume(ML) 97.53 ± 15.62, defecation urgency sense threshold(ML) 82.76 ±32.35, 72 hours colon excretion rate(%) 81.3 ± 13.7, 72 hours colon discharge grain 16.7 ± 3.7, pelvic floor muscle abnormal contraction rate(%) 14.29, rectal compliance(ml/mm Hg) 3.87 ± 0.78. Two groups before and after treatment in patients with SAS, SDS and symptom score, initial perception threshold, the maximum tolerable volume, defecation urgency expulsion rate, 72 hours colon discharge grain number, pelvic floor muscle abnormal contraction rate, rectum adaptation have significant changes(P < 0.05) infective threshold, 72 hours of colon. The total effective rate of the experimental group was similar to that of the control group, and there was no difference(P > 0.05).The total effective rate of the experimental group was similar to that of the control group, and there was no difference(P > 0.05). The experimental group SAS, SDS, symptom score, urgency of defecation, 72 hours of colonic discharge rate, 72 hours of colonic discharge, rectal compliance were lower than the control group, statistically significant difference(P < 0.05).After sixth months follow-up, the experimental group: 7 cases were cured, 14 cases were markedly effective, 11 cases were effective, 3 cases were ineffective, the symptom score was 4.45 ± 2.42. In the control group, 6 cases were cured, 13 cases were markedly effective, 10 cases were effective, 6 cases were ineffective, the symptom score was 5.75 ± 2.36.At the end of the treatment, the patients in the two groups and treatment after the end of the 6-month follow-up compared symptom score, there was no difference in the(P > 0.05), the experimental group total efficiency and similar to that of the control group, difference(P > 0.05). In the experimental group and the control group, the symptoms score, defecation urgency sense threshold, 72 hours colon discharge rate, 72 hours colon exhaust particle number comparison, the difference is statistically significant(P < 0.05).Conclusion:Comprehensive analysis before treatment, after treatment, treatment after the June in two groups of patients with efficiency, SAS, SDS and symptom score, anorectal manometry indexes, 72 hours colon discharge rate(grain), that the two methods in the treatment of functional constipation curative effect exact, near future curative effect is stable.