慢性便秘是临床常见功能性疾病，主要分为出口梗阻型、结肠慢传输型和混合型。生物反馈治疗出口梗阻型便秘(包括盆底失弛缓型和盆底松弛型)为首选治疗方法。在临床实践中需要根据诊断和鉴别诊断选择最佳适应证，根据盆底生理学检查的亚型分类制定治疗方案，病人和治疗师的配合及依从性是影响临床疗效的关键因素。训练括约肌收缩的持续时间比肌力更重要。单纯生物反馈治疗疗效不佳，可以结合电刺激、针灸、中医中药、肉毒素注射、手术等治疗。

Biofeedback therapy in chronic constipation        DING Shu-qing.  Department of Anorectal Diseases, the Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210001, China
Abstract    Chronic constipation is a common functional disorder. The subsets include out-let obstructive type, slow transit and mixed type. Biofeedback therapy is the first line option in out-let obstructive dominantly including pelvic floor dyssynergia and pelvic floor relaxation. In clinical practice, pelvic floor physiology tests are applied to choose the best indication candidates. Specific protocol, patient-therapist cooperation and patient passion are the key effectiveness contributions. The pelvic floor muscle tonic contraction and endurance training play more important role than muscle strength. Electrical stimulation, acupuncture, Chinese herb, botulinum injection and minor operation are alternatives when pure biofeedback therapy is unsatisfied.