CAJ | 학술논문

背景:非手术疗法治疗颈椎病是目前常用的治疗方法.这些方法都涉及到力学作用,尤其是颈椎牵引及推拿按摩的力学性质更加显著.目的:通过比较牵引和推拿按摩与单一牵引对颈椎病患者的干预效果,对不同康复方法中力的依从性进行探讨.设计:病例对比观察.单位:四川大学华西医院康复中心.对象:选择2002-10/2003-07在四川大学华西医院康复中心门诊就诊的符合非手术治疗的颈椎病患者52例,均自愿参加观察.随机分为2组,实验组和对照组各26例.方法:①实验组采用牵引和推拿按摩术相结合的方法.牵引1次/d,30 min/次,5次为1个疗程,治疗一两个疗程.推拿按摩8～10 min/次,1次/d,5次为1个疗程,治疗一两个疗程.②对照组则采用单纯的牵引方法.采用颈椎疾患治疗成绩评分表,选用表中临床症状、临床检查、日常生活3大项目作为评分标准.根据治疗前后评分计算改善指数:改善指数=(治疗后评分-治疗前评分)/治疗后评分.治疗后由医师进行评定改善指数.显效:临床症状、体症明显改善,对工作、学习和日常生活影响小;有效:临床症状、体症有改善,工作、学习部分受影响;无效:临床症状、体症无改善,工作、学习和日常生活同治疗前.主要观察指标:①两组患者治疗前后的颈椎疾患治疗成绩评分.②两组患者治疗后的干预效果.结果:颈椎病患者52例全部进入结果分析,无脱落.①两组患者治疗前后的颈椎疾患治疗成绩评分比较:治疗后实验组患者的颈椎治疗评分明显高于对照组[16.431 ±3.212,13.147±3.036(t=4.676,P＜0.01)],且实验组患者颈椎功能改善指数也明显高于对照组[0.505±0.163,0.368±0.145(t=3.860,P＜0.01)].②两组患者治疗后的干预效果比较:实验组的显效率高于对照组(80.8%,46.2%).结论:牵引和推拿按摩术相结合对颈椎病患者的干预效果优于单纯牵引疗法.不同的康复方法,其力学特性不同,干预效果也有较大的差异,表明力的变化对康复效果有明显影响. 揹景:非手術療法治療頸椎病是目前常用的治療方法.這些方法都涉及到力學作用,尤其是頸椎牽引及推拿按摩的力學性質更加顯著.目的:通過比較牽引和推拿按摩與單一牽引對頸椎病患者的榦預效果,對不同康複方法中力的依從性進行探討.設計:病例對比觀察.單位:四川大學華西醫院康複中心.對象:選擇2002-10/2003-07在四川大學華西醫院康複中心門診就診的符閤非手術治療的頸椎病患者52例,均自願參加觀察.隨機分為2組,實驗組和對照組各26例.方法:①實驗組採用牽引和推拿按摩術相結閤的方法.牽引1次/d,30 min/次,5次為1箇療程,治療一兩箇療程.推拿按摩8～10 min/次,1次/d,5次為1箇療程,治療一兩箇療程.②對照組則採用單純的牽引方法.採用頸椎疾患治療成績評分錶,選用錶中臨床癥狀、臨床檢查、日常生活3大項目作為評分標準.根據治療前後評分計算改善指數:改善指數=(治療後評分-治療前評分)/治療後評分.治療後由醫師進行評定改善指數.顯效:臨床癥狀、體癥明顯改善,對工作、學習和日常生活影響小;有效:臨床癥狀、體癥有改善,工作、學習部分受影響;無效:臨床癥狀、體癥無改善,工作、學習和日常生活同治療前.主要觀察指標:①兩組患者治療前後的頸椎疾患治療成績評分.②兩組患者治療後的榦預效果.結果:頸椎病患者52例全部進入結果分析,無脫落.①兩組患者治療前後的頸椎疾患治療成績評分比較:治療後實驗組患者的頸椎治療評分明顯高于對照組[16.431 ±3.212,13.147±3.036(t=4.676,P＜0.01)],且實驗組患者頸椎功能改善指數也明顯高于對照組[0.505±0.163,0.368±0.145(t=3.860,P＜0.01)].②兩組患者治療後的榦預效果比較:實驗組的顯效率高于對照組(80.8%,46.2%).結論:牽引和推拿按摩術相結閤對頸椎病患者的榦預效果優于單純牽引療法.不同的康複方法,其力學特性不同,榦預效果也有較大的差異,錶明力的變化對康複效果有明顯影響.
배경:비수술요법치료경추병시목전상용적치료방법.저사방법도섭급도역학작용,우기시경추견인급추나안마적역학성질경가현저.목적:통과비교견인화추나안마여단일견인대경추병환자적간예효과,대불동강복방법중력적의종성진행탐토.설계:병례대비관찰.단위:사천대학화서의원강복중심.대상:선택2002-10/2003-07재사천대학화서의원강복중심문진취진적부합비수술치료적경추병환자52례,균자원삼가관찰.수궤분위2조,실험조화대조조각26례.방법:①실험조채용견인화추나안마술상결합적방법.견인1차/d,30 min/차,5차위1개료정,치료일량개료정.추나안마8～10 min/차,1차/d,5차위1개료정,치료일량개료정.②대조조칙채용단순적견인방법.채용경추질환치료성적평분표,선용표중림상증상、림상검사、일상생활3대항목작위평분표준.근거치료전후평분계산개선지수:개선지수=(치료후평분-치료전평분)/치료후평분.치료후유의사진행평정개선지수.현효:림상증상、체증명현개선,대공작、학습화일상생활영향소;유효:림상증상、체증유개선,공작、학습부분수영향;무효:림상증상、체증무개선,공작、학습화일상생활동치료전.주요관찰지표:①량조환자치료전후적경추질환치료성적평분.②량조환자치료후적간예효과.결과:경추병환자52례전부진입결과분석,무탈락.①량조환자치료전후적경추질환치료성적평분비교:치료후실험조환자적경추치료평분명현고우대조조[16.431 ±3.212,13.147±3.036(t=4.676,P＜0.01)],차실험조환자경추공능개선지수야명현고우대조조[0.505±0.163,0.368±0.145(t=3.860,P＜0.01)].②량조환자치료후적간예효과비교:실험조적현효솔고우대조조(80.8%,46.2%).결론:견인화추나안마술상결합대경추병환자적간예효과우우단순견인요법.불동적강복방법,기역학특성불동,간예효과야유교대적차이,표명력적변화대강복효과유명현영향.
BACKGROUND:Non-operation therapies are commonly used in the treatment of cervical spondylopathy. All of these therapies involve biological mechanics; especially for traction and massage of the cervical vertebrae, they have an obvious property of biological mechanics in rehabilitation of the cervical vertebrae. OBJECTIVE: To probe into the biological mechanics of different rehabilitation methods through comparing the intervention effects between traction and traction combined with massage on cervical spondylopathy.DESIGN: A case-controlled observation. SETTING: Rehabilitation Center of West China Hospital of Sichuan University. PARTICIPANTS: Among the patients who came to the Rehabilitation Center of West China Hospital of Sichuan University between October 2002 and July 2003 for the treatment of spondylopathy, totally 52 patientsmet the criteria for non-operation therapy. They participated in the experiment voluntarily and were randomly divided into 2 groups: the experimental group and the control group, with 26 patients for each. METHODS: ①The patients in the experimental group were treated by traction in combination with massage. Traction was performed once a day,30 minutes each time, 5 times as a course of treatment, and one or two courses of treatment in total. Massage was performed for 8 to 10 minutes each time, once a day, 5 times as a course of treatment, and one or two courses in total. ② The patients in the control group were treated with traction only. Cervical Spondylopathy Therapeutic Effect Rating Scale was adopted to evaluate the effects, three items were selected to set as our scoring criterion, which included clinical symptoms, physical examinations and activities of the daily life (ADL). The improvement index was figured out on the basis of the pre-treatment score and post-treatment score. The improvement index is worked out by the following equation: improvement index = (The post-treatment score-pre-treatment score) / the post-treatment score. The improvement index was evaluated by physicians after the treat ment. Effectual: Clinical symptoms and body symptoms were obviously improved; work, learning, and daily life are not affected. Effective: Clinical symptoms and body symptoms have improved , and work, learning, and the daily life are partially affected. In-effective: There was no improvement in clinical symptoms and body symptoms and showed no effect on the work ,learning, and the daily life. MAIN OUTCOME MEASURES: ① Score of the treatment of cervical spondylopathy of the patients before and after the treatment. ② Intervention effect on the patients after the treatment RESULTS: Totally 52 patients with cervical spondylopathy entered the stage of result analysis with none missing in the midway. ① Comparison of the scores of the treatment of cervical spondylopathy of the patients before and after the treatment: After the treatment, the score in the experimental group was significantly higher than that in the control group [ 16.431 ±3.212,13.147 ±3.036 ( t =4.676, P ＜ 0.01 )], and the improvement index of the patients in the experimental group was significantly higher than that in the control group [0.505±0.163,0.368±0.145 (t=3.860, P ＜ 0.01 )]. ② Comparison of the intervention effects on the patients after the treatment: The effectual rate of the experimental group was higher than that of the control group (80.8%,46.2%).CONCLUSION: The approach of traction combined with massage is superior to simple traction. Different rehabilitation approaches have different properties in biological mechanics. It has showed that the force change is important to therapeutic effectiveness on cervical spondylopathy.