Short-Term And Long-Term Efficacy Of Female Patients With Relaxed Pelvic Floor Syndrome-Constipation Treated By Acupuncture And Biofeedback

ObjectiveTo observe the short-term and long-term clinical effectiveness of acupuncture combined with biofeedback therapy in the treatment of female patients with relaxed pelvic floor syndrome-constipation(RPFS-C).MethodsFrom January 2015 to August 2019,we collected 801 patients with relaxed pelvic floor syndrome-constipation who treated in the constipation clinic of Nanjing Hospital of Chinese medicine and was recorded in the database of "intelligent medical multi-functional integrated information management system" in the pelvic floor center.A total of 190 female patients received acupuncture combined with biofeedback therapy,and 161 patients with complete data were selected for standardized follow-up by telephone.The scales include:Constipation Scoring System Scale(CSS),Patient-Assessment of Constipation Quality of Life Questionnaire(PAC-QOL),Bristol Stool form Scale(BSFS)and the Chronic Constipation PRO Rating Scale(CC-PRO).The effectiveness,satisfaction,disease severity,quality of life and related influencing factors were evaluated at the end of treatment(short-term)and during follow-up(long-term).Results1.A total of 161 female patients with relaxed pelvic floor syndrome-constipation met the inclusion criteria.At the end of treatment,the CSS scores(14.59±3.98VS8.60±4.01)and PAC-QOL scores(84.48±19.82VS59.79±17.81)were lower than those before treatment(P<0.01).The CC-PRO scores of 22 patients after treatment(180.55±47.84VS121.45±55.20)was significantly lower than that before treatment(P<0.01).At the end of the treatment,6 cases(3.73%)were cured,23 cases(14.29%)were good effective,96 cases(59.63%)were general effective.The recent effective rate was77.65%,and the overall satisfaction rate for the short-term efficacy was 80.20%.2.A total of 148 patients(91.93%)were effectively followed up for 6 months to 4 years in the whole group(median follow-up time was 16 months).The CSS scores of 148 cases was 14.44± 3.96,8.41±3.97 and 9.87±4.31before treatment,at the end of treatment and during follow-up respectively(P<0.01).The PAC-QOL scores of 148 patients were 83.31 ± 19.04?59.01 ± 17.45?65.53±19.14,respectively(P<0.41).During the long-term follow-up of 148 patients,4 cases(2.70%)were cured,9 cases(6.08%)were good effective,80 cases(54.05%)were general effective,so the long-term effective rate was 62.83%,and the total satisfaction rate of long-term efficacy was 62.16%.3.The curative effect of acupuncture combined with biofeedback in the treatment of female relaxed pelvic floor syndrome-constipation was related to the course of disease,the course of treatment and whether there was assisted defecation(P<0.05),but not to pregnancy frequency,age,disease severity,family training,history of pelvic floor surgery and other diseases(P>0.05).Conclusion1.Acupuncture combined with biofeedback therapy can improve the symptoms of female patients with relaxed pelvic floor syndrome-constipation,including the degree of difficulty in defecating,sense of exhaustion,time,frequency,stool quality and abdominal distention,which can improve the quality of life,and achieve satisfactory and lasting clinical efficacy.2.The therapy of acupuncture combined with biofeedback is simple,safe and non-invasive,and it is feasible.The patients are highly satisfied with the efficacy evaluation.3.The course of disease,the course of treatment and assisted defecation affect the curative effect.