背景:功能性便秘(FC)是儿童中常见的全球高患病率问题。
目的:本研究的目的是评估内脏操作(VM)对标准治疗无反应的慢性交互式FC儿童的影响。
方法:本研究以随机,单盲对照试验。将52例对标准药物治疗无反应的难治性慢性功能性便秘儿童随机分为两组,每组26例(标准医疗护理(SMC))和26例(带有VM的SMC),为期4周。腹痛,痛苦的排便,大便稠度,排便频率,使用疼痛评定量表在治疗前后评估口服泻药的剂量,布里斯托尔粪便形成鳞片,和病人/家长报告。
结果:治疗结束时,除了对照组口服泻药的剂量,两组均有显著性差异(P<0.05)。干预组口服泻药剂量明显下降(P<0.05),然而,对照组无明显变化(P>0.05)。在干预组比较中,除布里斯托尔粪便形式量表外,所有患者的差异均具有统计学意义(P<0.05)。治疗后的Bristol粪便形式量表在组间比较时没有差异(P=0.32),但干预组大便稠度正常的人数明显高于对照组(P<0.05)。
结论:VM可以被认为是治疗慢性FC的一种除SMC外没有副作用的可能治疗方法。需要进一步的研究来研究VM的长期影响。
BACKGROUND: Functional constipation (FC) is a common global high prevalence issue in children.
OBJECTIVE: The purpose of the present study is to evaluate the effect of visceral manipulation (VM) on children with chronic interacble FC unresponsive to the standard treatment.
METHODS: This study was conducted as a randomized, single-blind controlled trial. Fifty-two children with refractory chronic functional constipation unresponsive to the standard medical treatment were randomly allocated to two groups of 26 control (standard medical care (SMC)) and 26 intervention (SMC with VM) for 4 weeks. Abdominal pain, painful defecation, stool consistency, defecation frequency, and the dose of oral laxative were evaluated before and after the treatment period using the Pain Rating Scale, Bristol stool form scale, and patient/parents report.
RESULTS: At the end of treatment, except for the dose of oral laxative in the control group, all of the results showed a significant difference in both groups (P<0.05). The dose of oral laxative in the intervention group decreased significantly (P<0.05), however, no significant change was observed in the control group (P>0.05). In the intervention group comparison, statistically significant differences were found in all va-riables except the Bristol stool form scale (P<0.05). The Bristol stool form scale after treatments was not different when the groups were compared (P=0.32), but the number of subjects who had normal stool consistency was significantly increased in the intervention group than in the control group (P<0.05).
CONCLUSIONS: VM can be considered as a possible treatment without side effects besides SMC for the management of chronic FC. Further studies are needed to investigate the long-term effect of VM.