摘要
背景目前神经根型颈椎病(CSR)的患病人群越来越趋于年轻化,并且发病率不断上升。传统功法八段锦对患者颈肩周围肌群、脊柱和心理状态有明显的保健康复作用,但不易坚持锻炼。目的观察改良八段锦“前三式”对CSR患者临床症状、焦虑、疼痛及生活质量的疗效。方法选取2021年3—8月在复旦大学附属中山医院康复医学中心就诊的CSR患者72例,采用随机分组软件将其分为常规康复组(36例)和改良八段锦组(36例)。常规康复组接受常规康复治疗,包括红外线、牵引、深层肌肉放松刺激(DMS)、改良旋转位颈椎关节松动术,治疗3次/周,连续治疗4周。改良八段锦组在常规康复组基础上再接受改良八段锦“前三式”锻炼,3次/周,连续治疗12周。于治疗前及治疗后4、8、12周,分别采用田中靖久颈椎病症状量表20分法、焦虑自评量表(SAS)、颈部疼痛视觉模拟量表(VAS)、中文版简明健康调查简表(SF-36)对患者的整体症状、焦虑程度、疼痛及生活质量进行评估。结果研究过程中,常规康复组脱落4例,剔除异常数据2例;改良八段锦组脱落3例,剔除异常数据3例,最终常规康复组和改良八段锦组各纳入30例。治疗后4、8、12周,改良八段锦组田中靖久颈椎病症状量表20分法评分、SF-36评分均高于常规康复组(P<0.05),SAS评分、颈部疼痛VAS评分均低于常规康复组(P<0.05)。改良八段锦组治疗后4周田中靖久颈椎病症状量表20分法评分、SF-36评分高于治疗前,SAS评分、VAS评分低于治疗前;治疗后8周田中靖久颈椎病症状量表20分法评分、SF-36评分高于治疗前、治疗后4周,SAS评分、VAS评分低于治疗前、治疗后4周;治疗后12周田中靖久颈椎病症状量表20分法评分、SF-36评分高于治疗前、治疗后4周、治疗后8周,SAS评分、VAS评分低于治疗前、治疗后4周、治疗后8周(P<0.05)。结论改良八段锦“前三式”改善CSR患者的临床症状、焦虑程度、疼痛及生活质量的疗效确切,且省时、便捷,值得在CSR患者临床及家庭常规康复训练中推广运用。
Background Cervical spondylotic radiculopathy(CSR)prevalence is increasing,and it tends to be higher in younger people.The traditional Baduanjin exercise has obvious effects on improving the functions of muscles around the neck and shoulder,spine functions and mental state,but it is difficult to adhere to the exercise.Objective To examine the effect of modified first three postures of Baduanjin on improving clinical symptoms,anxiety,pain and quality of life anxiety and quality of life in CSR patients.Methods Seventy-two CSR patients were recruited from Rehabilitation Medicine Clinic,Fudan University Zhongshan Hospital from March to August 2021 and equally divided into a usual rehabilitation group and a modified Baduanjin group based on a computer-generated randomized algorithm.Both groups received usual rehabilitation interventions,including infrared therapy,traction,deep muscle stimulation(DMS),and modified rotational cervical joint loosening,three times a week for a total of 4 weeks.The modified Baduanjin group additionally received modified first three postures of Baduanjin,3 times a week,for 12 consecutive weeks.Cervical vertebra status was assessed by Yasuhisa Tanaka 20 Score Scale(YT20SS),level of anxiety was assessed by the Zung Self-rating Anxiety Scale(SAS),the level of neck pain was assessed by the Visual Analogue Scale(VAS),and the quality of life was assessed by the Chinese version of the 36-item Short Form Survey(SF-36-C)at baseline,and the end of four,eight and 12 weeks of interventions.Results Except for 12 cases(four dropouts and two with abnormal data in the usual rehabilitation group,three dropouts and three with abnormal data in the modified Baduanjin group),the remaining 60 cases were included for analysis.Compared with the usual rehabilitation group,modified Baduanjin group had higher YT20SS and SF-36-C,and lower SAS and VAS scores after four,eight,and 12 weeks of interventions(P<0.05).In modified Baduanjin group,the results of the 4 measurements revealed that there were significantly successive increases in YT20SS and SF-36-C(P<0.05),and significantly successive decreases in SAS and VAS scores(P<0.05).Conclusion The modified first three postures of Baduanjian are time-saving and easy-to-perform,could contribute to the improvement of clinical symptoms,anxiety,neck pain and quality of life in CSR patients.Moreover,they are time-saving and easy-to-perform,so they are worthy of application and promotion for clinical rehabilitation and home-based usual rehabilitation for CSR.
作者
屠金康
李方方
付腾飞
吴晓琼
陈静
陆伟伟
沈归紫薇
陈君
TU Jinkang;LI Fangfang;FU Tengfei;WU Xiaoqiong;CHEN Jing;LU Weiwei;SHEN Guiziwei;CHEN Jun(Rehabilitation Medicine Center,Fudan University Zhongshan Hospital,Shanghai 200032,China;A Ward,Yangzhi Rehabilitation Hospital,Tongji University,Shanghai 201613,China)
出处
《中国全科医学》
CAS
北大核心
2022年第30期3783-3788,共6页
Chinese General Practice
基金
国家重点研发计划项目(2020YFC2008404-2)
上海市临床重点专科项目(shslczdzk02703)。
关键词
颈椎病
神经根型颈椎病
改良八段锦
焦虑
生活质量
田中靖久颈椎病症状量表20分法
康复
Cervical spondylosis
Cervical spondylotic radiculopathy
Modified Baduanjin
Anxiety
Quality of life
20-Score Scales of Symptoms
Rehabilitation
