整骨疗法对新冠肺炎患者康复的疗效观察

A. F. Belyaev, O. Fotina, T. S. Kharkovskaya, A. Yurchenko
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On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO2), pulse oximetry was performed. Rehabilitation included in the main group osteopathic correction (2 procedures), breathing exercises (4 procedures) and chest massage (4 procedures); in the control group there were breathing exercises (4 procedures) and chest massage (4 procedures). The rehabilitation course lasted 14 days. For the statistical analysis of the obtained data the Statistica-10 software package was used.Results. The studies revealed a pronounced change in the function of external respiration in patients who had undergone coronavirus pneumonia. According to the results of spirometry, more than 90 % of patients showed a statistically signifi cant (p=0.006) decrease in VC compared to the physiological norm — both in the main group (VC down to 80.7 %) and in the control group (VC down to 87.6 %), as well as a signifi cant (p=0.0001) decrease in FVC to 77.7 % in the main group and to 79.1 % in the control group. After rehabilitation, patients in the main group showed a statistically signifi cant improvement in the function of external respiration, manifested in an increase in VC by 12.3 % (p<0.0001), FVC by 12.1 %. In patients in the control group (without osteopathic correction), after the rehabilitation, the main indicators of the function of external respiration also improved, but the changes were not statistically signifi cant. As a result of rehabilitation, the patients of the main group showed a statistically signifi cant SpO2 increasing (from 96.6±0.2 to 97.5±0.2 %, p=0.0013); in the control group, there was also a positive dynamics of these indicators, but the changes were not statistically signifi cant.Conclusion. 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On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO2), pulse oximetry was performed. 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引用次数: 3

摘要

介绍。新型冠状病毒感染(COVID-19)大流行影响了许多人的生活。肺部的任何感染和炎症过程都可能导致整个机体的不良后果。影响肺、支气管呼吸结构的病理过程导致外部呼吸系统各环节的中断;因此,及时有效的对这类患者进行康复治疗,可以提高患者的生活质量,缩短暂时性残疾的时间,最重要的是恢复患者的外呼吸功能。目的是为了证明整骨疗法在冠状病毒肺炎患者康复中的应用效果。材料和方法。在滨海椎体神经病学和手工医学研究所(符拉迪沃斯托克)的基础上,采用整骨疗法对冠状病毒肺炎患者进行康复治疗。将63例冠状病毒肺炎患者随机分为临床和功能特征具有可比性的两组。第一组(主要组)34例,平均年龄65.5±1.5岁,其中男性44.1%,女性55.9%。对照组28例(平均年龄64.1±1.6岁),其中男性32.1%,女性67.9%。为了评估外呼吸功能,进行肺活量测定,并评估肺肺活量的主要指标(肺活量- VC,肺活量-强迫肺活量)。采用脉搏血氧仪测定动脉血中血红蛋白的含氧饱和度(SpO2)。康复包括主组整骨矫正(2个程序)、呼吸练习(4个程序)和胸部按摩(4个程序);对照组进行呼吸练习(4个程序)和胸部按摩(4个程序)。康复疗程14天。采用statistic -10软件包对所得数据进行统计分析。这些研究显示,冠状病毒肺炎患者的外呼吸功能发生了明显变化。肺活量测定结果显示,与生理正常值相比,90%以上患者的肺活量(VC)下降有统计学意义(p=0.006),主组(VC降至80.7%)和对照组(VC降至87.6%);肺活量(FVC)下降有统计学意义(p=0.0001),主组为77.7%,对照组为79.1%。康复后,主组患者外呼吸功能改善有统计学意义,表现为VC升高12.3% (p<0.0001), FVC升高12.1%。对照组患者(未进行骨科矫正)康复后,外呼吸功能主要指标也有所改善,但变化无统计学意义。经康复治疗后,主组患者SpO2由96.6±0.2提高至97.5±0.2,p=0.0013,差异有统计学意义;在对照组中,这些指标也有正动态变化,但变化无统计学意义。本研究结果表明,将整骨矫正方法纳入冠状病毒肺炎患者的康复治疗中,对患者的状态有积极的影响,改善了患者的外呼吸功能指标——VC和FVC,提高了患者的SpO2。获得的结果可以推荐将整骨疗法纳入冠状病毒感染患者的康复计划。
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The effectiveness of rehabilitation of patients after covid pneumonia with osteopathic methods
Introduction. The new coronavirus infection (COVID-19) pandemic has affected the lives of many people. Any infectious and infl ammatory process in the lungs can lead to adverse consequences for the whole organism. The pathological process affecting the respiratory structures of the lungs, bronchi leads to disruption of various links of the external respiration system; therefore, timely effective rehabilitation for such patients can improve the quality of life, reduce the period of temporary disability, and most importantly, restore the function of external respiration.The aim was to prove the effectiveness of the osteopathic methods application in the rehabilitation of patients after coronavirus pneumonia.Materials and methods. On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO2), pulse oximetry was performed. Rehabilitation included in the main group osteopathic correction (2 procedures), breathing exercises (4 procedures) and chest massage (4 procedures); in the control group there were breathing exercises (4 procedures) and chest massage (4 procedures). The rehabilitation course lasted 14 days. For the statistical analysis of the obtained data the Statistica-10 software package was used.Results. The studies revealed a pronounced change in the function of external respiration in patients who had undergone coronavirus pneumonia. According to the results of spirometry, more than 90 % of patients showed a statistically signifi cant (p=0.006) decrease in VC compared to the physiological norm — both in the main group (VC down to 80.7 %) and in the control group (VC down to 87.6 %), as well as a signifi cant (p=0.0001) decrease in FVC to 77.7 % in the main group and to 79.1 % in the control group. After rehabilitation, patients in the main group showed a statistically signifi cant improvement in the function of external respiration, manifested in an increase in VC by 12.3 % (p<0.0001), FVC by 12.1 %. In patients in the control group (without osteopathic correction), after the rehabilitation, the main indicators of the function of external respiration also improved, but the changes were not statistically signifi cant. As a result of rehabilitation, the patients of the main group showed a statistically signifi cant SpO2 increasing (from 96.6±0.2 to 97.5±0.2 %, p=0.0013); in the control group, there was also a positive dynamics of these indicators, but the changes were not statistically signifi cant.Conclusion. The results of the study allow to conclude that the inclusion of osteopathic correction methods in the rehabilitation of patients after coronavirus pneumonia has a positive effect on their state, improves the external respiration function indicators — VC and FVC, and also increases the SpO2. The obtained results allow to recommend the inclusion of osteopathic methods in the rehabilitation programs for patients who have undergone coronavirus infection.
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