表面肌电信号评价呼吸电刺激治疗功能性便秘的疗效
Evaluation of the effect of respiratory electrical stimulation training in patients with functional constipation by surface electromyography signal
目的 利用表面肌电测量腹肌、膈肌和盆底肌肌电改变,评价呼吸电刺激治疗功能性便秘的疗效。 方法 共31例功能性便秘患者纳入研究，按随机数字表法分为对照组和治疗组，对照组采用单纯盆底生物反馈治疗（16例），治疗组在盆底生物反馈治疗基础上进行呼吸电刺激训练（15例）。分别于治疗前以及治疗后对两组选用便秘评分系统进行评估，采用表面肌电图技术检测膈肌和下腹肌表面肌电均方根，Glazer法评估盆底肌肌电参数。 结果 治疗2周后，两组患者便秘评分系统评估较治疗前下降（P<0.05），且治疗组评分低于对照组（P<0.05）；两组患者的膈肌和腹直肌均方根值较治疗前改善（P<0.05），且治疗组膈肌肌电均方根值改善程度与对照组比较有统计学差异（P<0.05）。治疗后，Glazer法评估两组患者前基线、后基线波幅值较治疗前降低（P＜0.05），且治疗组前基线波幅值较对照组降低，差异有统计学意义（P<0.05）。 结论 呼吸电刺激训练可有效提高膈肌、腹肌收缩力,降低盆底肌的过度活动，增强盆底生物反馈治疗改善功能性便秘的治疗效果。
Objective To adopt electromyography for measuring abdominal muscles and diaphragmatic surface electromyographic change, and to use CSS for evaluation of the effect of respiratory electrical stimulation training in patients with functional constipation. Methods The study enrolled 31 patients with functional constipation，who were randomly divided into control group and treatment group. The control group was treated with biofeedback therapy (16 cases), and the treatment group was treated with respiratory electrical stimulation and pelvic floor biofeedback (15 cases).Surface electromyography technique was used to measure the surface electromyogram of the diaphragm and the lower abdomen，respectively, before treatment and after treatment in two groups with CSS，Glazer method was used to evaluate the parameters of pelvic floor muscle. Results After 2 weeks of treatment， severity score of patients with chronic constipation in the two groups lower than that before treatment（P<0.05）.And the score of the treatment group was lower than that of the control group（P<0.05）. root mean square value of the diaphragm and rectus muscle in patients of the two groups is better than that before treatment（P<0.05）. But there was significant difference between the treatment group and the control group（P<0.05）.After treatment，the Glazer method was used to evaluate the baseline amplitude values in two groups of patients, which demonstrated a lower value after treatment（P＜0.05）. The Anterior baseline amplitude of the treatment group was lower than that of the control group, and the difference was statistically significant（P＜0.05）. Conclusion The respiratory electrical stimulation training can effectively improve the contractility of diaphragm and abdominal muscles and reduce the excessive activity of pelvic floor muscles, and enhance pelvic floor biofeedback in the treatment of functional constipation.
Respiratory electrical stimulation training / Surface electromyography / Functional constipation / Biofeedback
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