Clinical Efficacy Observation Of Acupuncture Treatment Of Functional Constipation Based On Self-limiting Of The Disease

ObjectiveThe clinical efficacy and lasting effect of acupuncture treatment on Functional Constipation(FC)were evaluated by considering the self-limited of this disease.MethodsSeventy-six patients with FC who met the inclusion criteria were randomly divided into the acupuncture group(Group A)and the waiting-list group(Group B)according to a 1:1ratio,and the patients in the two groups received different treatment protocols.In the acupuncture group,the bilateral Tianshu acupoint,the Zusanli acupoint,and the Shangjuxu acupoint were chosen,with 5 sessions per week and 10 sessions in total.In the waiting-list group,patients did not receive any intervention during the trial.Both groups were evaluated for efficacy before treatment,at the end of treatment,and at 12-week follow-up after the end of treatment.The Patient Assessment of Constipation Symptom(PAC-SYM),the Patient Assessment of Constipation Quality of Life(PAC-QOL)were used to evaluate the improvement of clinical symptoms and quality of life in the two groups.and the Heart rate variability(HRV)was used to evaluate the changes in autonomic function of the patients.Results1.Sixty-nine subjects completed the trial,including 34 patients in the acupuncture group and 35 patients in the waiting group.2.The baseline clinical data showed no statistical difference between the two groups of FC patients,except for age(p < 0.05).3.Clinical efficacy evaluationWithin-group comparison: In the acupuncture group,the total score of PAC-SYM and the score of abdominal symptoms,the total score of PAC-QOL and the four dimensions of PAC-QOL,the values of SDNN,SDNNI,RMSSD,PNN50 and Hf in HRV parameters of patients were significantly decreased(p < 0.05)after treatment.After two-week waiting,the total score of PAC-SYM,the fecal symptoms of PAC-SYM,the rectal symptoms of PAC-SYM,the total score of PAC-QOL and the psychosocial discomfort dimension of PAC-QOL,and the satisfaction dimension of PAC-QOL,the values of SDNN and SDANN in HRV parameters of patients were significantly lower than baseline(p < 0.05).Between-group comparison: the changes of the total score of PAC-SYM,PAC-SYM abdominal symptom dimension score,the total score of PAC-QOL,PAC-QOL somatic discomfort dimension,PAC-QOL worry and anxiety dimension,PAC-QOL satisfaction dimension,and the p NN50 and LF/HF of patients in acupuncture group showed statistically significant differences(p < 0.05)compared with the patients in waiting-list group.Follow-up evaluation: the total score of PAC-SYM and its three dimension scores,the total score of PAC-QOL and its four dimension scores of patients in the acupuncture group were significantly lower after 3-month follow up than baseline(p < 0.05),and the fecal symptoms of PAC-SYM were also statistically different compared with the post-treatment period(p < 0.05).The total score of PAC-SYM,the fecal symptoms of PAC-SYM,and the rectal symptoms of PAC-SYM were significantly lower in the waiting treatment group compared to the group at enrollment(p < 0.05),the total score of PAC-QOL and its four dimensions were significantly lower compared to the group at enrollment(p < 0.05),and the PAC-SYM rectal symptoms dimension score,PAC-QOL worry and anxiety dimension score,and PAC-QOL satisfaction score were significantly lower compared to the group at 2 weeks of enrollment(p <0.05).The results of the comparison between groups showed that there was no statistical difference between the two groups in the improvement values of the total score of PAC-SYM and each dimension score,and the improvement values of the total score of PAC-QOL and each dimension score(p>0.05).Conclusion1.FC is a certain self-limited disease.With the extension of time,its clinical symptoms and life quality show a certain tendency of self-healing.2.Acupuncture treatment is safe and effective for FC.Acupuncture is effective in improving FC patients’ clinical symptoms and quality of life.3.Acupuncture might improve constipation symptoms of patients with FC by promoting the restoration of balance of autonomic nervous function and enhancing gastrointestinal motility.4.Due to the self-limiting nature of the disease,acupuncture treatment of FC can be flexibly adjusted according to the individual patient’s condition in order to obtain a more sustainable effect and save medical resources.