Objective:To study the optimization of defecation treatment in patients with chronic constipation under different positions and angles by "simulation contrast agent".Methods:The clinical data of 78 patients with chronic constipation in Handan Central Hospital from April 2020 to April 2022 were retrospectively analyzed. Among them, 26 patients were examined by 90°conventional defecography position (conventional position group), 26 patients by 60° to 89° defecography position (61° to 89° position group), and 26 patients by 30° to 59° Asian squat defecography position (Asian squat position group). The results of defecography, constipation score and defecography abnormality were compared among the three groups.Results:The encysted rectum, internal rectal intussusception and descending distance of perineum in 61° to 89° position group and Asian squat position group were significantly lower than those in conventional position group: (2.71 ± 0.25) and (2.11 ± 0.66) mm vs. (3.06 ± 0.23) mm, (9.06 ± 1.78) and (8.55 ± 2.81) mm vs. (10.22 ± 1.59) mm, (11.52 ± 2.70) and (10.52 ± 2.93) mm vs. (12.52 ± 3.43) mm, the indexes in Asian squat position group were significantly lower than those in 61° to 89° position group, and there were statistical differences ( P<0.01); the anal right angle and the anal right angle in force discharge state in 61° to 89° position group and Asian squat position group were significantly higher than those in conventional position group: (120.47 ± 3.35)° and (122.44 ± 3.33)° vs. (118.19 ± 3.66)°, (19.99 ± 3.47)° and (20.25 ± 2.69)° vs. (18.77 ± 2.79)°, the indexes in Asian squat position group were significantly higher than those in 61° to 89° position group, and there were statistical differences ( P<0.01); there was no statistical difference in resting anal right angle among the three groups ( P>0.05). The Longo outlet obstructive constipation score, Wexner constipation score and constipation severity score in 61° to 89° position group and Asian squat position group were significantly lower than those in conventional position group: (14.41 ± 2.66) and (12.24 ± 3.49) scores vs. (16.64 ± 3.37) scores, (13.79 ± 2.74) and (12.83 ± 3.08) scores vs. (15.76 ± 3.56) scores, (13.34 ± 2.72) and (12.31 ± 2.52) scores vs. (16.08 ± 3.57) scores, the indexes in Asian squat position group were significantly lower than those in 61° to 89° position group, and there were statistical differences ( P<0.01). The detection rates of abnormal defecography in conventional position group, 61° to 89° position group and Asian squat position group were 96.15% (25/26), 84.62% (22/26) and 69.23% (18/26), and there was statistical difference ( P<0.05); among them, the detection rate of abnormal defecography in Asian squat position group was significantly lower than that in conventional position group, and there was statistical difference ( P<0.05). Conclusions:The defecation function and imaging indexes are optimized in patients with chronic constipation based on the guidance of "simulation contrast agent" adopted the Asian squat position, and their significantly.