The Research On The Characteristics Of Pelvic Floor Dysfunction In Female Functional Anorectal Pain And Functional Anorectal Pain Syndromes Differentiation Of Chinese Medicine

Objective1.To observe the characteristics of the pelvic floor dysfunction,the severity and the quality of life of the female functional anorectal pain.2.To observe the distribution of TCM syndromes of the functional anorectal pain.3.To observe the relationship between TCM Syndromes and severity of the functional anorectal pain..MethodsCollecting 100 cases with female functional anorectal pain as the chief complaint from Nanjing Municipal Hospital of Chinese Medicine colorectal department clinic from September 2015 to February 2017.With a careful history,patients completed the questionnaires including Pain visual analogue scale(VAS),Short Form-36 Questionnaire(SF-36)and Chinese medicine syndrome differentiation form.If combined with constipation,fill in the Constipation Scoring System(CSS)and Patient-Assessment of Constipation Quality of Life(PAC-QOL).If combined with urinary incontinence,fill in the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)and Urinary Incontinence Quality of Life Questionnaires(I-QOL);if combined with fecal incontinence,fill in Fecal Incontinence Severity Score Scale(Wexner)and Fecal Incontinence Quality of Life Questionnaire(FI-QOL).If finding other symptoms through the relevant examination,such as rectocele,etc.marking in the pelvic floor disease diagnosis system diagram.All data will be filled into the Pelvic Floor Information Database,and analysis the clinical characters of Functional Anorectal Pain,the distribution of the TCM syndrome,then compared and analysis the relationship between the Chinese Medicine Syndromes and symptom severity score.Results1.100 cases of female Functional Anorectal Pain are aged 33 to 84(57.67± 10.45)years;The number of Chronic Proctalgia(CP)is 95 cases and Proctalgia Fugax(PF)is in 5 cases,of which 45 cases of Levator ani Syndrome(LAS);In terms of the nature of the pain,There are 88 cases of pain on the fall pain,tingling in 8 cases;In terms of the area of pain,79 cases of pain is in the anus and 15 cases in perianal;Pain can radiate to the perineum,sacrococcygeal,abdomen and other parts;In 100 cases,simple anal rectum pain accounted for 19%(19 cases)and with one or more symptoms accounted for 81%(81 case);The combined symptoms are mainly divided into defecation,urination,and pain.Among them,bowel movements were classified as:53 cases of constipation(24 cases of pelvic floor relaxation syndrome,17 cases of pelvic floor relaxation loss syndrome,4 cases of mixed constipation,8 cases of type IBS constipation),and 10 cases of fecal incontinence;Urination class is divided into 48 cases of urinary incontinence,5 cases of nocturia,7 cases of frequency urination and 2 cases of urination disorders;There were 10 cases of vaginal pain in the pain class;Other groups such as 17 cases of rectocele,1 cases of prolapse of uterus and 3 cases of prolapse of rectum,were found by correlation examination.Through the relevant examination also found that 1 case of uterine prolapse,3 cases of rectal mucosal prolapsed and so on.2.Clinical distribution of TCM syndromes in 100 functional anorectal pain patients dyndromes distribution were listed:Qi stagnation and blood stasis(n=24),spleen-QI sinking(n=24),hepatosplenic disorder(n=18),deficiency of liver-yin and kidney-yin(n=10),Spleen kidney yang deficiency(n=10),Dampness and heat injection(n=1).VAS was between 2 and 10 points(5.1±2.19),in which there are 33 cases of mild pain,moderate in 39 cases,severe in 28 cases;The SF-36 score was from 14.4 to 137.0 points(74.49±31.31),in which there are 26 cases of poor quality of life,46 cases of moderate quality of life,26 cases of better quality of life.There was no significant difference(P>0.05)between the TCM syndrome types and pain severity and quality of life among the groups.Conlusion1.Patients of female functional anorectal pain with pelvic floor dysfunction accounted for 81%,mainly for constipation,urinary incontinence,accounted for 53%,48%,others including fecal incontinence,nocturia,urinary frequency,vaginal pain etc.2.There are four kinds of TCM syndrome types of functional anorectal pain,mainly including Qi stagnation and blood stasis and spleen-QI sinking,accounting for 37%and 24%.3.There is no relationship between the TCM syndrome type and the severity of functional anorectal pain.