本文選題：個性化康復(fù) + 頸椎病��； 參考：《上海交通大學(xué)》2015年碩士論文

【摘要】：目的:在頸椎病及腰椎間盤突出癥患者間實施推廣個性化的康復(fù)指導(dǎo)方案,觀察該治療方法對頸椎病及腰椎間盤突出癥患者軀體功能康復(fù)療效的影響。方法:60例頸椎病及腰椎間盤突出癥患者,年齡30-50歲,隨機(jī)分為兩組:一組給予常規(guī)康復(fù)治療及宣教指導(dǎo),為對照組;另一組給予常規(guī)康復(fù)治療基礎(chǔ)上,予個性化評估及個性化康復(fù)指導(dǎo),以口頭、書面、照片、視頻等形式,為個性化組。分別在治療前,治療后每周一次,治療結(jié)束時由第三方盲法,應(yīng)用疼痛視覺模擬評分(Visual Analogue Scale,VAS)、日本骨科學(xué)會(Japanese Orthopedic Association,JOA)下背痛或頸椎評分、SF-36簡明健康問卷(the MOS 36-item Short From Health Survey)進(jìn)行評估。結(jié)果:觀察者取自2014年9月至2015年1月上海市第一人民醫(yī)院康復(fù)科門診及康復(fù)中心就診患者,其中男27例,女33例,平均年齡39.37(±6.40)歲,所有患者均進(jìn)入結(jié)果分析,無脫落。采用單因素方差分析進(jìn)行統(tǒng)計,治療前兩組患者的VAS、JOA、SF-36得分水平無顯著差異(P0.05);在治療1周后,對照組和個性化組患者的VAS得分分別5.20±1.10和4.43±1.20,存在顯著統(tǒng)計學(xué)差異(F=6.714,P0.05);兩組JOA得分分別為16.00±2.32和17.47±2.45,同樣存在顯著統(tǒng)計學(xué)差異(F=5.680,P0.05)。2周的治療結(jié)束時,對照組和個性化組的VAS得分分別為4.13±1.28和2.73±1.26,差異非常顯著(F=18.270,P0.01);兩組JOA得分為17.20±2.40和19.40±3.36,存在非常顯著統(tǒng)計學(xué)差異(F=8.524,P0.01);兩組SF-36評分分別為114.37±14.30,123.03±13.10,組間比較有顯著統(tǒng)計學(xué)差異(F=5.990,P0.05)。對多個時間點的組間、組內(nèi)比較使用重復(fù)測量方差分析,結(jié)果顯示隨時間變化兩組有VAS降低、JOA和SF提高的趨勢,并且時間因素的作用隨著分組的不同而不同,個性化組的整體療效趨勢好于對照組。結(jié)論:相比單采用常規(guī)康復(fù)治療及指導(dǎo),同時對頸椎病及腰椎間盤突出患者進(jìn)行個性化的康復(fù)指導(dǎo)可取得更優(yōu)效果。
[Abstract]:Objective: to investigate the effect of individualized rehabilitation guidance program on the physical function of patients with cervical spondylosis and lumbar disc herniation. Methods Sixty patients with cervical spondylosis and lumbar disc herniation, aged 30-50 years, were randomly divided into two groups: one group was treated with routine rehabilitation therapy and the other group was treated with routine rehabilitation therapy. Personalized evaluation and individualized rehabilitation instruction, in oral, written, photo, video and other forms, for personalized group. Before and once a week after treatment, the patients were evaluated by the third party blind method with visual Analogue scale and Japanese Orthopedic Association / JOA-Japanese Orthopedic Association / Japanese Orthopedic Association (JOAA). Results: observers were collected from outpatients and rehabilitation centers of the first people's Hospital of Shanghai from September 2014 to January 2015. There were 27 males and 33 females with an average age of 39.37 (鹵6.40) years. Using univariate analysis of variance, there was no significant difference in VAS-JOASF-36 score between the two groups before treatment, and after one week of treatment, there was no significant difference in the scores of VAS-JOASF-36. The VAS scores of the control group and the individualized group were 5.20 鹵1.10 and 4.43 鹵1.20, respectively. There was significant statistical difference between the two groups (P < 0.05), the JOA scores of the two groups were 16.00 鹵2.32 and 17.47 鹵2.45, respectively. The scores of VAS in control group and individuation group were 4.13 鹵1.28 and 2.73 鹵1.26, respectively, the difference was very significant (P < 0.05), the scores of JOA in two groups were 17.20 鹵2.40 and 19.40 鹵3.36, respectively. The scores of SF-36 in two groups were 114.37 鹵14.30123.03 鹵13.10, respectively. The results showed that VAS decreased JOA and SF increased in two groups over time, and the effect of time factors varied with different groups. The overall therapeutic effect of the individualized group was better than that of the control group. Conclusion: compared with routine rehabilitation therapy and guidance, individualized rehabilitation guidance for patients with cervical spondylosis and lumbar disc herniation can achieve better results.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R681.55

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