The Effect Of Different Frequency Magnetic Stimulation Of Sacral Nerve On Outlet Obstructive Constipation

Objective To evaluate the effect of magnetic stimulation of sacral nerve at different frequencies on adult outlet obstructive constipation,and determine the optimal treatment frequency of magnetic stimulation of sacral nerve for outlet obstructive constipation.Methods From November 2021 to November 2022,the outpatient department of rehabilitation medicine of**Hospital recruited 80 patients with outlet obstructive constipation,aged 18 years old and above,according to the inclusion and exclusion criteria.The patients with outlet obstructive constipation were confirmed by the evaluation of Rome Standard Ⅲ and needed physical treatment.The patients were randomly divided into high-frequency group or low-frequency group,and received magnetic stimulation of sacral nerve for 6 weeks on the basis of conventional motor therapy and biofeedback therapy.The main observation results will be the patient’s Knowles eccersley scott symptom(KESS),anorectal manometry,pelvic floor surface electromyography and pelvic floor elastic color ultrasound results.Results Compared with the scores of KESS scale in the two groups,the scores of the two groups after treatment were lower than those before treatment,and the data before and after treatment were significantly different(P<0.05);In comparison between groups,the difference of KESS score before and after treatment in the high-frequency group was(6.13 ± 4.08)points,and the difference of KESS score in the low-frequency group was(4.08± 1.62)points.The difference between the high-frequency group and the low-frequency group was more significant(P<0.05).The changes of constipation symptom scores in the two groups focused on defecation frequency,stool morphology,abdominal distension,defecation time and other items.the intra-group comparison of pelvic floor surface electromyography in the two groups showed that the resting variation,slow muscle variation and endurance variation decreased(P<0.05);Comparison between groups:resting variation,slow muscle variation,endurance variation,high frequency group decreased more than low frequency group(P<0.05),fast muscle maximum(MAX),slow muscle mean,endurance mean,etc.,high frequency group increased more than low frequency group(P<0.05);Compared with the anorectal manometry group,the anal contractile force MAX of the two groups decreased,and the continuous extrusion time increased(P<0.05);The first sense channel,defecation sensation and maximum tolerance increased in the high frequency group(P<0.05),while the first sense channel,defecation sensation and maximum tolerance decreased in the low frequency group(P<0.05);Inter-group comparison:Compared with the low-frequency group,the high-frequency group has a more significant difference in reducing the anal contraction force MAX and increasing the continuous extrusion time(P<0.05).Intra-group comparison of pelvic floor elastic color ultrasound:The mean value of internal anal sphincter,mean value difference of internal anal sphincter,mean value difference of external anal sphincter and mean value difference of puborectalis muscle in two groups after Valsalva action and at rest decreased(towards negative value)compared with those before treatment,with significant difference(P<0.05).Comparison between groups:There was no significant difference in the mean difference of internal anal sphincter and puborectalis muscle between the two groups,but there was significant difference in the mean difference of external anal sphincter between the two groups(P<0.05),and the decrease in high frequency group was more than that in low frequency group.Conclusions Compared with 15Hz,30Hz magnetic stimulation of sacral nerve can improve the therapeutic effect of constipation,improve the intestinal peristalsis function of patients,and have obvious effect in improving the strength and stability of defecation-related muscles.