【摘要】 目的:观察中药熏蒸联合肌肉能量技术的治疗方法,配合璟云康复平台进行的家庭康复训练对强直性脊柱炎患者功能障碍恢复的效果;探讨改善强直性脊柱炎患者功能障碍可行的医院-家庭一体化治疗的方法。方法:选取符合诊断及纳入标准的80例强直性脊柱炎活动期患者作为研究对象,按照随机数字表法分为试验组42例和对照组38例。对照组采用中药熏蒸、肌肉能量技术和药物治疗,中药熏蒸每次30 min,肌肉能量技术每次40 min,中药熏蒸和肌肉能量技术均每天1次,每周5次,每个月第1周为治疗时间,6个月共治疗6周;药物治疗为口服塞来昔布,每次200 mg,每天2次,连续3个月。试验组在对照组基础上加用璟云康复平台进行家庭康复训练,按照云平台系统提示完成动作并将所完成的动作录制成视频传到云端,临床康复治疗师进入后台检查动作完成情况,动作规范合格后再进行下一阶段临床治疗及家庭康复训练。第一阶段,每次30 min,每天3次,持续3个月;第二阶段,每次30 min,每天2次,持续3个月。比较2组治疗前后疼痛视觉模拟评分(VAS)、关节活动度(ROM)、肌力、Bath强直性脊柱炎病情活动指数(BASDAI)、Bath强直性脊柱炎功能性指数(BASFI)、强直性脊柱炎Schober试验评分、红细胞沉降率(ESR)、C反应蛋白(CRP)水平。结果:2组治疗前VAS评分、颈椎ROM、胸椎ROM、腰椎ROM、肌力、BASDAI、BASFI、Schober评分、ESR、CRP水平比较,差异无统计学意义(P>0.05);2组治疗后VAS评分、BASDAI、BASFI、ESR、CRP均较治疗前明显降低,颈椎ROM、胸椎ROM、腰椎ROM、肌力、Schober评分均较治疗前明显升高,差异有统计学意义(P<0.01);治疗后,试验组VAS评分、BASDAI、BASFI、ESR、CRP较对照组明显降低(P<0.05),颈椎ROM、腰椎ROM、肌力、Schober评分较对照组明显升高(P<0.05)。结论:中药熏蒸联合肌肉能量技术治疗强直性脊柱炎有效,加用璟云康复平台进行家庭康复训练效果更好,有利于缓解患者腰背痛及脊柱功能的整体恢复,帮助强直性脊柱炎患者实现医院-家庭一体化的康复治疗。更多还原

【Abstract】 Objective: To observe the effect of treatment of Chinese medicine fumigation and muscle energy technology, combined with family rehabilitation training by Jinyun rehabilitation platform on dysfunction improvement of patients with ankylosing spondylitis(AS), and explore a hospital-family integrated treatment approach that is feasible for dysfunction improvement of AS patients. Methods: A total of 80 AS patients with active stage who met the diagnostic and inclusion criteria were randomly assigned to the experimental group(n=42) and the control group(n=38). The control group was treated with Chinese medicine fumigation, muscle energy technology and anti-inflammatory painkillers. The treatment of Chinese medicine fumigation for AS patients was about 30 minutes each time, and the treatment of muscle energy technology was about 40 minutes each time. The frequency of the two kinds of treatment was once a day, five times a week, the first week of each month was chosed as the treatment time, and there should be six weeks of treatment time in six months. The anti-inflammatory painkiller was oral celecoxib, 200 mg each time, twice a day, and the treatment lasted for three weeks. The experimental group received the family rehabilitation training management of Jingyun rehabilitation platform on the base of the control group. The AS patients completed the action as prompted by the platform, then recorded a video to the platform; the rehabilitation therapists entered the backstage and checked the completion of the action; the AS patients could enter into next stage of clinical treatment and rehabilitation training when their movements were qualified. The family rehabilitation training was divided into two phases, in the first phase, the treatment time of three months lasted about 30 minutes each time, three times a day; in the second phase, the treatment time of three months lasted about 30 minutes each time, two times a day. After treatment, the visual analogue score(VAS), rang of motion(ROM), muscle strength, Bath AS disease activity index(BASDAI), Bath AS functional index(BASFI), Schober test score, erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) were compared between the two groups. Results: Before treatment, there was no significant difference in VAS, ROM, muscle strength, BASDAI,BASFI, Schober score, ESR and CRP between the two groups(P>0.05). After treatment, the VAS, BASDAI, BASFI, ESR and CRP were decreased(P<0.01), and the ROM, muscle strength and Schober score were increased in two groups compared with before treatment(P<0.01). After treatment, the VAS, BASDAI, BASFI, ESR and CRP in the experimental group were lower than those of the control group(P<0.05), and the cervical vertebrae ROM, lumbar vertebrae ROM, muscle strength and Schober score were higher than those of the control group(P<0.05). Conclusion: Chinese medicine fumigation combined with muscle energy technology is effective for treating low back pain of AS patients. Under these treatments, adding Jingyun rehabilitation platform for family rehabilitation training can effectively improve the treatment effect of low back pain, promote the overall recovery of the patient’s spinal function, and help the AS patients to achieve a hospital-family integrated treatment approach.更多还原