Efficacy Of Cranial Electrotherapy Stimulation Combined With Biofeedback Therapy In Treatment Of Functional Constipation

Objective To explore the effects of Cranial Electrotherapy Stimulation(CES) combined with Biofeedback Therapy(BFT) on psychological state, clinical symptom and anorectal function in patients with Functional Constipation(FC).Methods In this randomized controlled trail, patients with FC who visited Pelvic Floor Center, Nankai University Affiliated Hospital, Tianjin, China, between March 2014 and July 2015 were enrolled. Totally 149 patients with FC were divided into two groups randomly. Control group received BFT. CES combined with BFT was carried out in the experiment group. All patients were assessed using Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS) and Wexner Constipation Score(WCS) at baseline and the end of each course. The Short Form-36 Health Survey(SF-36) was completed before and after treatment. Anorectal Manometry(ARM) and Balloon Expulsion Test(BET) were performed before and after treatment. All statistical analyses were performed using SPSS version 18.0(SPSS Inc., Illinois, USA). Continuous variables were presented as mean ± standard deviation and categorical variables presented as frequencies and proportions. The Chi-squared test was used for comparison of non-continuos parameters(Baseline data and BET). The difference of SF-36 scores and the changes of ARM values between the experiment group and the control group before and after treatment were examined with Student's t test. Analysis of temporal changes in scores(SAS, SDS and WCS) at 4 different time points was performed using repeated measures analysis of variance(ANOVA). All P-values reported were two-sided and a P-value < 0.05 was regarded as statistically significant.Results After treatment, the participants in experiment group had significant lower scores of SAS, SDS and WCS than the control group(all P < 0.001). After treatment, the participants in experiment group had significant higher scores of six dimensions of SF-36(Physical Functioning, PF; Bodily Pain, BP; General Health, GH; Role-emotional, RE; Vitality, VT; Mental Health, MH) than the control group(all P < 0.001). The number of successful expulsion in the experiment group was larger than the control group(P = 0.012).Conclusions CES combined with BFT was effective in improving psychological status of anxiety and depression, bowel symptom in patients with FC.