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Objective To study the changes of anorectal motility and rectal sensation in the elderly patients with ulcerative colitis (UC). Methods The anorectal motility and rectal sensation were investigated by Medtronic PC-Polygraf HR made by Sweden in 35 non-elderly patients versus 19 elderly patients with UC, and 20 non-elderly healthy subjects (HS) and 28 elderly HS were as control group. Results (1) The static pressure, pressure of anal sphincter and the maximal squeeze pressure of anal sphincter in non-elderly patients and elderly patients with UC showed no significant differences compared with those in non-elderly HS and elderly HS group (elderly patients with uc vs. ederly HA:t= 1.311,1.298,1.401;nonederly patients with uc vs. nonederly HS: t=1.294,1.299,1.322all P＞0.05). When abdominal pressure was increased, the net increased pressure of anal sphincter was (2.8±1.1) kPa in the elderly patients with UC, (2.9±1.3) kPa in the non-elderly patients with UC. The pressures were lower in two UC groups than in HS groups [elderly HS group:(3.8±1.2) kPa; non-elderly HS group:(3.9±1.2) kPa,elderly patients with uc vs. ederly HS:t=2.238,nonelderly patients with us vs. nonederly HS:t=2.243 all P＜0.05]. (2)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance were (85±30) ml, (180±69) ml, (26. 5±8.8) ml/kpa in elderly patients with UC and (65±15) ml, (170±58) ml, (22.6± 10. 3) ml/kPa in non-elderly patients with UC. They were lower than in each HS group [elderly HS group (95±31) ml, (205±78) ml, (32.9±12.9) ml/kPa; non-elderly HS group:(78±38) ml, (190±50) ml, (30.8± 15.2) ml/kpa, all P＜0. 01]. (3)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance in elderly patients with UC were higher than in non-elderly patients with UC (elderly patients with uc vs. elderly HS:t=3. 121,3. 135,3.146,nonederly patients with uc vs. non elderly HS: t= 3.162, 3.141, 3.188 elderly patients with uc vs. nonelderly patients with uc: t = 2. 246,2. 239,2. 240 all P＜ 0. 05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance in elderly HS group were higher than in non-elderly HS group (ederly HS vs. t = 2. 328,2. 301 all P＜0. 05). Conclusions There are some anorectal motility disturbances in UC. Higher sensitivity, lower tolerance, lower compliance of rectum and weakened anal automatic control function in UC may be associated with diarrhea and frequent defecation. The rectal sensation threshold to volume stimulus is higher in elderly HS than in non-elderly HS group. The sensibility to volume ectasis of rectum is weakened and the survivability of rectum is increased in elderly patients with UC.
ABSTRACT
Objective To study the effect of flupentioxl melitracen and pinaverium bromide treatment on the changes of anorectal motility and rectal sensation in the patients of diarrhea-predominant irritable bowel syndrome (IBS-D) accompanying with depression and/or anxiety status. Methods Forty-four patients with IBS-D accompanying with depression and/or anxiety status were divided into group A (flupentioxl melitracen and pinaverium bromide) and group B (pinaverium bromide) by random digits table,and treated for 4 weeks. Twenty-five healthy subjects were included as control group. The anorectal motility and rectal sensation before and after taking medicines were compared. Results When abdominal pressure was increased, the net increased pressure of anal sphincter was (3.0 ± 1.2 ) kPa in group A and (2.9 ± 1.2)kPa in group B. They were lower than that in control group [(3.6 ± 1.6) kPa](P＜ 0.05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were (55 ± 20) ml,( 145 ± 78 ) ml, ( 21.9 ± 12.9 ) ml/kPa in group A, ( 56 ± 38 ) ml, ( 150 ± 50 ) ml, (20.8 ± 11.2) ml/kPa in group B. They were lower than those in control group [(80 ± 38 ) ml, ( 190 ± 50 ) ml, (30.8 ± 15.2 ) ml/kPa](P ＜ 0.01 ). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were higher than those before taking medicines. Only the rectal lowest volume of sensory threshold in group B was higher than that before taking medicines. The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance in group A after taking medicines were higher than those in group B (P ＜ 0.05 or ＜ 0.01 ). Conclusions Higher sensitivity, lower tolerance,lower compliance of rectum and weakened anal automatic control function in IBS-D may be associated with diarrhea and frequent defecation. Treatment combining flupentioxl melitracen with pinaverium bromide may preferably improve the aperception functions of rectum in the patients of IBS-D accompanying with depression and/or anxiety status.
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Objective:To observe the clinical efficacy of tuina on infantile diarrhea.Method:Sixty-two cases were classified into five subtypes:diarrhea due to food injury,wind-cold,damp-heat,spleen deficiency and yang deficiency of the spleen and kidney.The manipulations including separating hand yin-yang,kneading the general tendon,pushing spleen-earth,transporting external Bagua,rubbing the abdomen,pressing Zusanli (ST 36),kneading Guiwei and pinching the spine were applied once a day.Result:After the treatments of 3 to 30,35 cases got recovery,21 got marked effect,and 6 got improvement.Conclusion:The infantile tuina treatment is effective for infantile diarrhea.