Objective: :Obstructed defecation syndrome (ODS) is a group of symptoms that are mainly caused by pelvic floor dysfunction concerning bowel symptoms. It is challenging in clinical practice. Acupuncture has advantages in the treatment of complex symptoms because of its multitarget and bi-directional regulation of the human body. Since, 2,500 years ago, acupuncture has been applied empirically to the treatment of constipation. Does acupuncture have any effect on ODS?
By showing the clinical thoughts, methods, and achievements of acupuncture series in ODS in recent ten years by the authorís team, and two scientific papers published in English on acupuncture treatment of chronic intractable constipation and stress urinary incontinence, it is proved that the core scheme of acupuncture treatment of ODS is flexible.
In order to raise awareness of the therapeutic effect of acupuncture in ODS, it can be integrated into existing practice to get opportunities for multi-disciplinary cooperation and further research and development.
Materials and Methods: :By summarizing the diagnosis and treatment of ODS, the first-line selection of pelvic floor rehabilitation and the minimally invasive sacral neuromodulation were reviewed, and it was pointed out that there was a gap between the high demand of patients and the expectation of cost-effectiveness. Then, on the basis of modern eastern and western medical achievements, the holistic concept was introduced into the treatment of pelvic floor dysfunction, and an acupuncture scheme suitable for ODS was proposed.
Results: :Acupuncture is based on the idea of improving the patientsí central nervous system, autonomic nervous system, and intestinal nervous system, and is effective in treating ODS. The acupoints were set in two groups when the patient in a supine position, which includes ST 25 (Tian Shu), SP 15 (Da Heng), SP 14 (Fu Jie), CV 6 (Qi Hai), CV 4 (Guan Yuan), ST 36 (Zu San Li), ST 37 (Shang Ju Xu); When a patient is in the prone position, it includes BL 20 (Pi Shu), BL 23 (Shen Shu), BL 25 (Da Chang Shu), BL 33 (Zhong Liso), BL 34 (Xia Liao), and GV 20 (Bai Hui). The key was the technique of deep needling of the ST 25 (Tian Shu) and deep needling of the BL 33 (Zhong Liso) & BL 34 (Xia Liao). It needs 2-15 Hz sparse-dense wave electrical stimulation, 30 minutes each time, a total of 20 times, which was a scheme that could achieve satisfactory short-term and long-term effects.
Conclusion: :At present, clinical and basic experimental studies have proved that acupuncture plays a role in treating ODS in a multi-target way. This is a very promising research direction of pelvic floor integrated medicine.
In the future, further study on optimizing the protocol and meeting the patientís gap individually and cost-effectively.
Corresponding Author: DING S.|