Efficacy And Mechanism Of Operation Combined With Psychological Intervention To Treat Dysporia Constipation

Objective: Treat dysporia constipation by operation combined with psychological intervention, clinical efficacy was observed and mechanism of diagnosis and treatment was initially explored, what the aim was to guide clinical treatment.Methods: 60 patients, from the out-patient section of anorectal and constipation of Xin Hua hospital affiliated to Da Lian University, in line with Rome III standard of constipation diagnosis, with operative indications, up to including and excluding, were selected. The patients were grouped into surgical treatment group(control group) and group of operation combined with psychological intervention treatment(experimental group) by treatment sequence. The routine surgical treatment was used in the control group, the psychological intervention treatment of cognition-coordination-structure-medicine was used in the experiment group before and after operation, the patient’s clinical symptom, state of psychological improvement, curative efficiency and expression levels of 5-HT, Ach and SP before and after treatment were compared.Results: Integrals of SAS and SDS of dysporia constipation were 47.1±12.9 and 51.3±12.2, what about Chinese norms were 37.2±12.6 and 41.9±10.6, significant difference(P<0.05); after treatment, defecation incompletion feeling, rectum and anus blocking feeling and total effective rate were 1.17±0.51, 1.25±0.58 and 23%, experimental group is superior to control group(P<0.05); before treatment, scores of SAS and SDS in control group were 53.21±8.01 and 44.85±8.13, what about experimental group were 54.44±6.65 and 43.34±7.15; after treatment, scores of SAS and SDS in control group were 44.29±5.80 and 40.08±6.49, what about experimental group were 39.77±5.19 and 36.98±4.73, there’s significant differences in SAS and SAS about two group(P<0.05); in experimental group, expression level of 5-HT and Ach in serum were 339.50±19.00 and 3.22±0.09 after treatment, and were 153.05±12.80 and 1.24±0.13 before treatment, compared with pre-treatment, there’s significant differences after treatment(P<0.05); compared with pre-treatment, there’s a descending tendency about SP, but no statistical significance(P>0.05).Conclusions: SDS and SAS score and symptom integral were positively correlated, the higher level of anxiety and depression, the heavier clinical symptoms; symptom integral and psychological state were significant improved after treatment by operation combined with psychological intervention and surgery alone, and experimental group is better than control group; After operation combined with psychological intervention treatment, expression level of 5-HT and Ach was significant changed; it mean that expression level of 5-HT and Ach has close relations with dysporia constipation.