The Effectiveness of Biofeedback for Patients with Functional Constipation：a Meta-analysis

doi:10.12114/j.issn.1007-9572.2018.00.132

Abstract

Abstract: Objective　To systematically evaluate the effectiveness of biofeedback on patients with functional constipation.Methods　From January 2007 to July 2016，randomized controlled trials were retrieved from multiple electronic databases including CNKI，CBM，Wanfang Data Knowledge Service Platform，VIP，PubMed，Cochrane Library，EMBase，Web of Science，JBI，RNAO，Nursing Consult，BIOSIS Previews，Medline and Springerlink.Studies were selected according to inclusion and exclusion criteria，and data were analyzed by RevMan 5.3.Results　A total of 8 RCTs with 688 patients were included.The results of meta-analysis supported the effectiveness of biofeedback on improving the subjective feelings of defecation in patients with functional constipation〔RR=1.47，95%CI（1.03，2.08），P=0.03〕 and reducing the need for digit use during defecation〔RR=0.47，95%CI（0.27，0.81），P=0.007〕.Biofeedback also improved the discharge rate of colonic transit test〔MD=9.83，95%CI（5.18，14.18），P<0.000 1〕，and decreased the anorectal pressure〔MD=-49.70，95%CI（-86.60，-12.79），P=0.008〕.Conclusion　Biofeedback can improve the subjective feelings of defecation in patients with functional constipation and discharge rate of colonic transit test，as well as reduce the need for digit use during defecation and the anorectal pressure with functional constipation.Due to the fact that effectiveness on improving patient satisfaction after treatment and decreasing the anal resting pressure are still not certain，with the heterogeneity of indicators and inadequate included studies，more multi-centered randomized controlled trials with large sample size and good quality are needed in the future to confirm the effectiveness of biofeedback.

Key words: Constipation, Biofeedback, Meta-analysis

摘要： 目的　系统评价生物反馈训练对功能性便秘患者的干预效果。方法　计算机检索中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据知识服务平台、中文科技期刊数据库（VIP）、PubMed、Cochrane Library、EMBase、Web of Science、JBI循证护理数据库、RNAO、Nursing Consult、BIOSIS Previews、Medline、Springerlink等数据库中关于生物反馈训练治疗功能性便秘患者的随机对照试验。检索时间为2007年1月—2016年7月。依据文献纳入及排除标准进行筛查，提取资料，评价文献质量，采用RevMan 5.3软件进行Meta分析。结果　最终纳入8项研究，包括688例研究对象。Meta分析结果显示，生物反馈训练治疗功能性便秘有效率高于对照组〔RR=1.47，95%CI（1.03，2.08），P=0.03〕，需人工协助排便比例低于对照组〔RR=0.47，95%CI（0.27，0.81），P=0.007〕，肠道标志物排出率高于对照组〔MD=9.83，95%CI（5.18，14.18），P<0.000 1〕，用力排便时肛门压低于对照组〔MD=-49.70，95%CI（-86.60，-12.79），P=0.008〕。结论　生物反馈训练能够有效改善功能性便秘患者的排便主观体验，降低需人工协助排便比例及用力排便时肛门压，提高肠道标志物排出率，但是否能降低患者的肛门静息压、提高满意度方面尚缺乏有力证据。由于本研究评价指标间存在异质性，因此，需要更多临床多中心、大样本、高质量的研究进一步评价生物反馈训练对功能性便秘患者的综合效果。

关键词: 便秘, 生物反馈, Meta分析

WU Xiaodan,ZHONG Jiudi,WEN Yongshan, et al. The Effectiveness of Biofeedback for Patients with Functional Constipation：a Meta-analysis[J]. Chinese General Practice, 2019, 22(5): 606-611. DOI: 10.12114/j.issn.1007-9572.2018.00.132.
吴晓丹,钟就娣,温咏珊等. 生物反馈训练对功能性便秘患者干预效果的Meta分析[J]. 中国全科医学, 2019, 22(5): 606-611. DOI: 10.12114/j.issn.1007-9572.2018.00.132.

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