【摘要】 目的 观察不同频率和波形电针八髎穴治疗非特异性肛门直肠痛的临床疗效。方法 将160例非特异性肛门直肠痛患者随机分为疏密波电针组、密波电针组、疏波电针组和对照组,每组40例。对照组予生物反馈治疗,其余3组均于八髎穴处进行电针治疗。疏密波电针组采用频率2 Hz/100 Hz的疏密波电针治疗,密波电针组采用频率100 Hz的密波电针治疗,疏波电针组采用频率2 Hz的疏波电针治疗。观察4组治疗前后疼痛视觉模拟量表(visual analog scale, VAS)评分、肛门直肠测压数据(肛管静息压和肛管收缩压)、焦虑自评量表(self-rating anxiety scale, SAS)评分、抑郁自评量表(self-rating depression scale, SDS)及36项健康调查简表(MOS 36-item short-form health survey, SF-36)评分的变化,比较4组临床疗效及不良反应发生率。结果 治疗后,4组VAS评分均较治疗前降低(P<0.05),3组电针组均低于对照组(P<0.05)。治疗后,4组肛管静息压和肛管收缩压均较治疗前降低(P<0.05),疏密波电针组和密波电针组肛管静息压均低于对照组(P<0.05)。治疗后,4组SAS评分与同组治疗前比较,差异无统计学意义(P>0.05);4组SDS评分较同组治疗前降低(P<0.05);疏密波电针组SDS评分低于对照组(P<0.05)。治疗后,4组SF-36各维度评分均较同组治疗前升高(P<0.05),疏密波电针组SF-36生理机能、躯体疼痛、一般健康状况和精力方面评分均高于对照组(P<0.05)。4组总有效率比较,差异无统计学意义(P>0.05)。治疗中,4组均未出现不良反应。结论 电针能缓解非特异性肛门直肠痛患者的疼痛,不同频率波形的电针疗效无明显差异,但疏密波电针和密波电针治疗存在潜在优势,能明显降低肛管静息压,改善患者抑郁症状,提高生活质量。更多还原

【Abstract】 Objective To observe the clinical efficacy of electroacupuncture(EA) with different frequencies and waveforms at Baliao points [Shangliao(BL31), Ciliao(BL32), Zhongliao(BL33), and Xialiao(BL34)] in the treatment of non-specific anorectal pain. Method A total of 160 patients with non-specific anorectal pain were randomized into a sparse-dense wave EA group, a dense wave EA group, a sparse wave EA group, and a control group, with 40 cases in each group. The control group received biofeedback therapy, and the other three groups received EA treatment at Bailiao points. The sparse-dense wave EA group received EA treatment with 2 Hz/100 Hz sparse-dense waves, the dense wave EA group received EA treatment with 100 Hz dense waves, and the sparse wave EA group received EA treatment with 2 Hz sparse waves. The four groups were observed before and after the treatment for changes in the visual analog scale(VAS) score, anorectal manometry parameters(anal resting pressure and anal squeeze pressure), self-rating anxiety scale(SAS) score, self-rating depression scale(SDS) score, and MOS 36-item short-form health survey(SF-36) score. The clinical efficacy and adverse reaction rate were compared among the four groups. Result After the treatment, the VAS score decreased in all four groups(P<0.05) and was lower in the three EA groups than in the control group(P<0.05). After the intervention, the anal resting pressure and anal squeeze pressure dropped in all four groups(P<0.05), and the anal resting pressure was lower in the sparse-dense wave EA group and dense wave EA group than in the control group(P<0.05). The post-treatment change in the SAS score was insignificant in the four groups(P>0.05), while the SDS score declined after the treatment in all four groups(P<0.05) and was lower in the sparse-dense wave group than in the control group(P<0.05). After the treatment, all four groups showed a increase in each dimension score of the SF-36(P<0.05), and the sparse-dense wave EA group was higher than the control group when comparing the SF-36 dimension scores of physical functioning, bodily pain, general health perceptions, and vitality(P<0.05). The differences in the total effective rate among the four groups were statistically insignificant(P>0.05). None of the four groups reported adverse reactions during the treatment. Conclusion EA can alleviate pain in patients with non-specific anorectal pain. There is no significant difference in the efficacy of EA among different frequencies and waveforms, but sparse-dense wave EA and dense wave EA demonstrate potential advantages as they can notably reduce anal resting pressure, improve depression symptoms, and enhance the quality of life in the patients.更多还原