The Basic And Clinic Study On The Mechanism Of Functional Anorectal Pain Treated By Acupuncture And Biofeedback

ObjectiveTo investigate the clinic meaning of the surface electromyography(sEMG) parameters in discussing the mechanism of acupuncture and biofeedback treating FARP and evaluating the curative effectiveness.Methods40 patients with FARP and 40 asymptomatic as controls were measured with a anal sEMG probe for collecting the sEMG parameters.All the patients were cured by acupuncture and biofeedback,after 2 sessions(10 treatments were a session),they were measured for sEMG parameters again.Results1.The differences of the sEMG between FARP group and the asymptomatic group(the control group):In Pre-baseline process,the mean amplitude(AVG) of FARP group was higher than the control group(P<0.01),and the median frequency(MF) was lower than the control group(P<0.01);In Flick process,the peak AVG of FARP group was lower than the control goup(P<0.01);In Work and Endurance processes,the AVG of the FARP group were both lower than the control group(P<0.01),and the Coefficient of Variance(CV) were both higher(P<0.01);In Post-baseline process,the AVG of FARP group was higher than the control group(P<0.01).2.After treating for 2 sessions:In Pre-baseline process,the AVG was lower and MF was higher than pretherapy (P<0.01);In Flick process,the peak AVG was higher than pretherapy (P<0.01);In Work and Endurance processes,the AVG were higher and CV were lower than pretherapy (P<0.01);In post-baseline process, the AVG was lower and the MF was higher than pretherapy(P<0.01).3.After treating for 2 sessions:The AVG of pre-baseline and the CV of Work and Endurance were also higher than the asymptomatic control group(P<0.01),while the MF of Work and Post-baseline were higher(P<0.01).4.After treating for 2 sessions:1 case was cured (2.5%),7 cases were markedly effective(17.5%),22 cases were effective(55%) and 10 cases were invalid(25%), the total efficiency was 75%;SF-36 sored higher than pretherapy in 7 items including:physical functioning,social functioning, vitality, mental health, role-emotional, role-physical, bodily pain(P<0.05) 5.The CV of Work and Endurance had significant correlation to curative effect(P<0.01).Conlusion1.The sEMG signals of FARP were significantly higher than those of the controls at rest,while the contactive amplitude were lower and the CV were higher during the state of contraction.2.The sEMG of FARP changed apparently after being treated by biofeedback and acupuncture,most parameters like amplitude at rest, contactive amplitude and CV were close to the control group.3.Treating FARP by acupuncture and biofeedback was effective,and the CV was a sensitive value to evaluate curative effect.4.Acupuncture can lower hypermyotonia, accommodate automatic nervous system(ANS) & central nervous system(CNS) and improve function of pelvic floor muscle by using eight-liao point (BL31,BL32, BL33,BL34).5.Biofeedback therapy can lower hypermyotonia, make pelvic floor muscle working more concordant and increase contraction force.