摘要
目的系统评价骶神经刺激(SNS)治疗功能性肛门痛的临床疗效。方法计算机检索中国知网、万方、中国生物医学文献数据库、PubMed、Web of Science数据库,查找有关SNS治疗功能性肛门痛的临床研究。系统评价SNS对患者疼痛评分(VAS)及测压变化的影响,采用Revman5.3进行Meta分析。结果共纳入5篇研究,共428例患者,其中SNS组339例,对照组89例。Meta分析结果显示:SNS可以降低VAS(SMD=-2.59,95%CI-4.81~-0.38,P=0.02),降低初始感觉阈值(SMD=-1.14,95%CI-1.41~-0.86,P=0.000),降低持续感觉阈值(SMD=-0.43,95%CI-0.69~-0.18,P=0.001),降低最大耐受量(SMD=-1.44,95%CI-1.72~-1.16,P=0.000),在静息压与收缩压的变化上,差异无统计学意义。敏感性分析显示静息压与收缩压的显著性均发生了较大改变,结果不稳定。结论SNS可以减轻功能性肛门痛患者的疼痛与改善直肠感觉。但仍需更多高质量、大样本的随机对照试验进一步论证。
Objective To systematically evaluate the clinical efficacy of sacral nerve stimulation(SNS)in the treatment of functional anorectal pain.Methods The database of CNKI,Wanfang,Chinese Biomedical Literature Database,PubMed and Web of Science were inquired by computer to search for the clinical studies on SNS in the treatment of functional anorectal pain.The effects of SNS on pain score( VAS) and manometric changes were systematically evaluated,and Meta-analysis was performed using Rev Man 5.3.Results A total of 5 studies and 428 patients were included,with 339 patients in SNS group and 89 patients in control group.SNS could decrease VAS( SMD =-2.59,95% CI-4.81 ~-0.38,P = 0.02,P = 0.000),the first sensory threshold( SMD =-1.14,95% CI-1.41 ~-0.86,P = 0.000),the persistent sensory threshold( SMD =-0.43,95% CI-0.69 ~-0.18,P = 0.001),and the maximum tolerable threshold( SMD =-1.44,95% CI-1.72 ~-1.16,P = 0.000),and there was no statistical significance in the changes of anal resting pressure and anal systolic pressure.Sensitivity analysis showed significant changes in both resting and systolic pressure,but the results were not stable.Conclusion SNS can relieve pain and improve rectal sensation in patients with functional anorectal pain.However,greater amount of high-quality RCTs literatures are required.
作者
李怡廷
吴桑嗓
黄学红
倪敏
Li Yiting;Wu Sangsang;Huang Xuehong(Anorectal Department,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210022,China)
出处
《四川医学》
CAS
2022年第5期487-491,共5页
Sichuan Medical Journal
关键词
骶神经刺激
功能性肛门痛
META分析
sacral nerve stimulation
functional anorectal pain
Meta-analysis
