The Clinical Research Of Heat-sensitive Point Moxibustion Combined With Biofeedback In Treatment Of Dyssynergic Defecation With Lung And Spleen Qi Deficiency Type

Objective: To observe the clinical efficacy of heat-sensitive point moxibustion combined with biofeedback in the treatment of dyssynergic defecation with qi-deficiency of lung and spleen,exploring its effectiveness and safety.Methods: 54 outpatients who had met the standard of the Anorectal Clinic of Xiamen Hospital of Traditional Chinese Medicine from March 2018 to November 2018 were randomly divided into test group(27 cases)and control group(27 cases).The test group was treated with heat-sensitive point moxibustion combined with biofeedback therapy,while the control one was treated with biofeedback therapy only.Both groups were treated for 3 courses,of which lasting 5 days.The data will have been recorded and statistical analysis will have been made to observe the total curative effect,improvement of clinical symptoms and anorectal manometry results between two groups before and after treatment and 1 month follow-up.Results: The research of 54 cases were completed.Got on a comparable analysis before the treatment of two groups,there was no significant difference(P>0.05).The specific results were as follows:1.After three courses of treatment,the total effective rate of the test group was 85.19%,and that of the control group was 74.07%.There was a significant difference between the two groups(P<0.05).The curative effect of the test group was better than that of the control group.(1)Analysis of cleveland constipation score: the frequency of defecation,and symptom of defecation straining,sensation of incomplete evacuation,abdominal pain,defecation time,defecation assistance and the number of invalid defecation before treatment were all improved in the test group(P<0.05),in which,the improvement of sensation of incomplete evacuation,defecation time and number of invalid defecation were better than those in the control group(P<0.05).In the control group,there was no significant improvement in the number of invalid defecation compared with that before(P>0.05).(2)Analysis of TCM quantitative score of lung and spleen qi deficiency type: TCM quantitative score of lung and spleen qi deficiency type: in the test group,there were significant improvements in terms of urging to have a bowel movement but difficult to defecate,sweating and short of breath after straining,fatigue after defecation,laziness,tongue picture and pulse condition(P<0.05),among them,the improvement of sweating and short of breath after straining,fatigue after defecation and laziness were better than those in the control group(P<0.05).In the control group,there was an significant improvement in those symptoms:urging to have a bowel movement but difficult to defecate,sweating and short of breath after straining and fatigue after defecation(P<0.05),but not in laziness,tongue picture and pulse condition(P>0.05).(3)Analysis of anorectal manometry: the resting anal sphincter pressure,anal sphincter relaxation rate,first rectal sensation and constant rectal sensation were improved in both groups(P<0.05),among them,the test group was better than the control group in improving sphincter relaxation rate,first rectal sensation and constant rectal sensation(P<0.05).The squeeze anal sphincter pressure and the maximum rectal tolerable sensation were improved in the test group(P<0.05),but not in the control group(P>0.05).2.After one month follow-up,the total effective rate of the test group was 81.48%,and that of the control group was 66.67%.There was a significant difference between the two groups(P<0.05).The curative effect of the test group was more stable than that of the control group.(1)As for the Cleveland Constipation Score,the improvement of symptoms in the test group did not change significantly after one month follow-up(P>0.05),while the efficacy of the control group in defecation straining and defecation time was lower than that before the follow-up(P<0.05).The test group was better than the control group in improving symptoms of defecation straining,sensation of incomplete evacuation,defecation time and defecation assistance(P<0.05).And there was no significant difference in defecation frequency,abdominal pain and the number of invalid defecation between the two groups(P>0.05).(2)With respect to TCM quantitative score of lung and spleen qi deficiency type,there was no significant change in the improvement of each syndrome in the test group after one month follow-up(P>0.05),but in the control group with the syndrome of urging to empty bowel but difficult to defecate(P<0.05).The test group was superior to the control group in improving syndromes of urging to have a bowel movement but difficult to defecate,sweating and short of breath after straining,fatigue after defecation and laziness(P<0.05),and there was no significant difference in tongue picture and pulse condition between the two groups(P>0.05).Conclusion:1.The therapy of heat-sensitive point moxibustion combined with biofeedback can significantly improve clinical symptoms,asynergic movement of pelvic floor muscles as well as rectal sensation in the treatment of patient who suffering from dyssynergic defecation with lung and spleen qi deficiency type,which indicate it is safe and effective.2.The clinical effect of heat-sensitive point moxibustion combined with biofeedback is better than that of simple biofeedback therapy,the results of follow-up for 1 month shows that the effect of improving clinical symptoms is stable,which remedy a defect of the dis-satisfactory long-term effect of biofeedback.As a result,we can say that the clinical practice of heat-sensitive point moxibustion combined with biofeedback therapy is promising.