成年人慢性便秘流行病学的研究现状

Assessment of reporting completeness in acupuncture studies on patients with functional constipation using the STRICTA guidelines

OBJECTIVE

To evaluate the completeness of reporting of acupuncture interventions in trials for functional constipation (FC) following the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines.

METHODS

We searched eight databases for all published trials, including clinical trials, pilot/feasibility studies, observational studies, and case studies, for acupuncture in patients with FC up to June 31, 2021. The completeness of reporting was evaluated using the STRICTA guidelines.

RESULTS

Finally, 99 studies were included and analysed based on the latest STRICTA guidelines. Out of the 17 analysed STRICTA sub-items, only five were found to be appropriately reported in more than 90% of the trials, while five were completely reported in less than 30%.

CONCLUSIONS

The reporting completeness of acupuncture trials for FC in accordance with STRICTA guidelines is moderate, with poor guideline adherence for several items. Clinical trial reports should be further improved in accordance with STRICTA guidelines to enhance the completeness of evidence. There is also a need to explore the underlying reasons as to why the authors did not report these items and to develop strategies for improving guideline compliance.

Chronic constipation and chronic disease management

Urbanization, population aging and lifestyle changes have resulted in great changes in global disease pattern and medical model. Chronic non-communicable diseases have become the main cause of premature death around the world in the 21^st century, and their prevention and control have also changed from "treatment" to "management". As a result, chronic disease management (CDM) model arises. Chronic constipation (CC) has a hidden onset, complex etiology, prolonged course, and high prevalence, and it can induce a variety of diseases and affect the quality of life seriously. Mainstream therapy for CC is empirical treatment for facilitating feces excretion, but it may lead to more serious symptoms. Application of the CDM model to CC management may solve this problem. In the current review, we will discuss the progress in research of CC and the current status of CDM.

Efficacy of Cranial Electrotherapy Stimulation Combined with Biofeedback Therapy in Patients with Functional Constipation

Background/Aims

A large number of studies have shown that function constipation (FC) has an extremely high incidence of mental and psychological disorders. Cranial electrotherapy stimulation (CES) was applied to the treatment of psychological disorders such as anxiety and depression. We explored the effects of CES combined with biofeedback therapy (BFT) on the psychological state, clinical symptoms, and anorectal function in patients with FC.

Methods

A total of 74 patients with FC were randomly divided into 2 groups. The control group received BFT. CES combined with BFT was carried out in the experiment group. All patients were assessed using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Wexner constipation score at baseline and the end of each course. Anorectal manometry and balloon expulsion tests were performed before and after treatment.

Results

After treatment, the participants in the experiment group had significantly lower score SAS, SDS, and Wexner constipation scores than the control group (all P < 0.05). The number of successful expulsion in the experiment group was larger than the control group (P = 0.016).

Conclusions

CES combined with BFT was effective in improving the psychological status of anxiety, depression, and bowel symptoms in patients with FC.

Curative effect of mosapride vs prucalopride in treatment of chronic constipation in elderly patients

AIM: To compare the curative effect between mosapride and prucalopride in the treatment of chronic constipation in elderly patients.

METHODS: From February 2013 to September 2014, 123 elderly patients with chronic constipation at our department were randomly assigned to orally receive either mosapride (control group, n = 61) or prucalopride (observation group, n = 62). The efficacy, time to first defecation, and time to improvement of difficult defecation were compared between the two groups. Moreover, the scores for common symptoms (defecation frequency, stool properties, defecation difficulty and defecation time) and adverse reactions were also recorded.

RESULTS: The total effective rate in the observation group was 83.61% (59/62), significantly higher than that of the control group [83.61% (51/61), P < 0.05]. Compared with the control group, the time to first defecation and time to improvement of difficult defecation were shortened, and common symptom scores decreased in the observation group (P < 0.05). Main adverse reactions included diarrhea, nausea and abdominal pain, and the duration of these adverse reactions was shorter. There was no statistical significance in the incidence of adverse reactions between the two groups (P > 0.05).

CONCLUSION: Prucalopride has a better curative effect than mosapride in the treatment of elderly patients with chronic constipation in terms of improved symptoms and tolerable adverse reactions.

Effect of cranial electrotherapy stimulation combined with biofeedback therapy on clinical symptoms and quality of life in patients with functional constipation

AIM: To explore the effect of cranial electrotherapy stimulation (CES) combined with biofeedback therapy (BFT) on clinical symptoms and quality of life in patients with functional constipation (FC).

METHODS: A total of 126 subjects with FC were included and divided into either a control group (n = 62) or an experimental group (n = 64). The control group was given BFT alone, and the experimental group received CES combined with BFT. The clinical symptom score was recorded, and the 36-Item Short Form-36 Health Survey (SF-36) was used to assess the quality of life.

RESULTS: After treatment, the experimental group revealed a much more significant decrease in overall symptom score and scores of difficult defecation and sensation of incomplete evacuation compared to the control group (P < 0.05). In the experimental group, the total effective rate was 43.65%, significantly higher than 36.51% in the control group (P < 0.05). The subcategories of SF-36 including general health perceptions, physical functioning, emotional role functioning, bodily pain, vitality and mental health in the experimental group displayed a significant increase compared with the control group after treatment (P < 0.05).

CONCLUSION: CES combined with BFT can improve clinical symptoms and quality of life in FC patients.