Intermediate Frequency Transcutaneous Electrical Nerve Stimulation Improves Constipation Symptom And Quality Life In Female Patients With Functional Constipation

Background and Objective: Functional constipation(FC)is a common gastrointestinal disease and mainly in female,affecting their physical and mental health severely.The traditional method of treatment depends on drugs mainly,but the efficacy is poor and has many side effects.Domestic and foreign scholars have been seeking non-drug methods for treatment of FC.Transcutaneous electrical nerve stimulation(TENS)is one of new developing methods of non-drug treatments of FC.Because of its good effect,noninvasive and low price,it have been favored by domestic and foreign experts.But its stimulation frequency,the site of stimulation,and the single stimulation time are inconformity,in addition,the mechanism of action is unclear.In this study,we breaked the low-frequency stimulation and selected of intermediate frequency stimulation to observe the effects of TENS for FC female patient's stool,constipation symptoms,psychological status by changing the single stimulation time.Methods: 20 female FC patients diagnosed by Rome III functional constipation diagnostic criteria were selected and divided then into group A(11 cases,single stimulus time :20 minutes)and group B(9 cases,single stimulation time: 40 minutes).Computing IF physiotherapy are applied to stimulate point ST36 and ST25,1 time a day,1 week treatment period.Before and after treatment,all patients were asked to sign Patient Assessment of Constipation Symptom(PAC-SYM),Patient Assessment of Constipation Quality Life Scale(PAC-QOL),self-rating anxiety scale / self-rating depression scale(SAS / SDS),and defecation log.The present experimental data are measured by SPSS17 and P <0.05 is considered statistically difference.Results1.General information comparison of two groups: All subjects were female and 18 were completed the treatment,age range 42-77 years.The mean age of two groups were(56.90±11.39)years and(57.00±12.92)years.The average time duration of the two groups were(8.60 ± 5.42)years and(7.63 ± 5.53)years.Respectively,there was no statistical difference between the two groups.2.Main outcome of TNES treatment2.1 Bowel movements per week independent: The number of bowel movements per week increased after treatment and there was significant difference(P_A = 0.001,P_B<0.001),but the number between the two groups have no significant difference(P =0.877).2.2 Stool: The stool scores of two groups were significantly increased after treatment and the difference was statistically significant(P_A = 0.006;P_B <0.001).Group B was better than group A,and there was significantly different between them(P =0.003).2.3 The time of defecation :No matter group A or B,the average time of defecation was decreased than before,but no significant difference before and after treatment(P_A =0.148,P_B = 0.057).2.4 weekly number of drugs: The average number of drugs of group A and B were decreased,but there was no significant difference(P_A = 0.138,P_B = 0.064).3.Secondary outcomes of TNES treatment3.1 PAC-SYM: The PAC-SYM scores of two groups were decreased,and there is significant difference(P_A = 0.012,P_B <0.001)after treatment,but no significant difference between two groups(P = 0.085).3.2 PAC-QOL: The PAC-QOL scores of two groups were significantly decreased,and there was statistically significant(P_A = 0.023,P_B <0.001).Compared with group B,there is no significant difference(P = 0.085).3.3 Associated symptoms Rating: The rectum symptom score and abdominal symptom scores of group A were not statistically significant difference;the rectum symptom score of group B decreased significantly(P <0.001);The abdominal symptoms scores group B decreased significantly(P = 0.011);The abdominal symptom scores of group A were significantly lower than group A,and they were significantly different between them(P = 0.044).3.4 Psychological conditions Rating: The SAS,and SDS scores of group A were no significant difference;The SAS,and SDS scores of group group B were significantlydifferent(PSAS <0.001,PSDS = 0.022).After treatment,SAS and SDS scores between two groups were no significant difference.Conclusion1.Intermediate frequency transcutaneous electrical nerve stimulation can significantly improve independent defecation frequency,stool,quality of life and psychological conditions of female patients with functional constipation.2.The efficacy of transcutaneous electrical nerve stimulation is better in the treatment of functional constipation by an appropriate extension single stimulation time.