证实在肩-肩痛综合征患者的复杂治疗中使用整骨矫正的可能性

Ch. K. Emelyanova, O. V. Zolkova, N. Kozlova
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By the method of randomization using randomization envelopes, the 20 patients were included in the control group and the 20 patients in the main group. Participants of the control group received standard drug and physiotherapy treatment, participants of the main group additionally received a course of osteopathic correction. In both groups, before and after treatment, there were assessed the osteopathic status, the severity of pain syndrome by a 10-point visual analogue scale, the state (functioning) of the shoulder joints, and daily life activities by a 30-point Swanson scale. The duration of temporary disability in both groups was also recorded.Results. At the start of the study, a number of regional (most often — the neck region, structural component, and the chest region — visceral and structural component) and local (most often — the shoulder joint and temporomandibular joint) somatic dysfunctions were detected in patients with humeroscapular syndrome. After treatment in the main group, a statistically significant (p<0,05) positive dynamics was recorded in relation to disorders of the neck region (structural component), thoracic region (visceral and structural component), and pelvic region (structural component). In the control group, significant positive dynamics was observed only in relation to disorders of the thoracic region (visceral component). The groups began to differ significantly (p<0,05) by the disorders detection frequency of the neck and pelvis region (structural component). Also a statistically significant (p<0,05) positive dynamics was recorded in relation to disorders of the shoulder joint and temporomandibular joint in the main group, and in the control group it was detected only in relation to the shoulder joint disorders. At the start of the study, patients in both groups were characterized by a fairly intense pain syndrome (mean score over seven in both groups). After treatment, significant (p<0,05) positive dynamics was observed in both groups, but in the main group the result was significantly (p<0,05) more pronounced: 1,6±0,89 points in the main group versus 2,7±0,86 points in the control group. The shoulder joints state and the daily life activity at the study start moment were characterized by relatively low rates — the average total value was no more than 15 points in both the control and main groups. After the treatment, significant (p<0,05) positive dynamics was observed in both groups, but in the main group the result was more pronounced: 28,0±1,86 points in the main group versus 22,1±2,34 points in the control group (p<0,05). The average duration of temporary disability in days was 8,1±1,07 days in the main group and 15,0±1,84 days in the control group, the difference between the groups is statistically significant (p<0,05).Conclusion. 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引用次数: 0

摘要

介绍。肩痛是人群中最常见的致残原因之一。现代治疗肩痛综合征的方法倾向于使用药物治疗。然而,频繁的副作用仍然与广泛采用非药物治疗方法有关。整骨疗法就是其中一种很有前途的方法。在这方面,评估肱骨肩胛骨疼痛综合征患者骨科矫正的有效性是有需求的。目的是证实在肩痛综合征患者的复杂治疗中使用整骨矫正的可能性。材料和方法。这项研究涉及40名患有肩痛综合征的患者。采用随机化信封随机化的方法,将20例患者分为对照组,20例患者分为主组。对照组患者接受标准药物及物理治疗,主组患者在此基础上进行1个疗程的整骨矫正。在治疗前后,两组患者均采用10分视觉模拟量表评估骨病状态、疼痛综合征严重程度、肩关节状态(功能)和日常生活活动(30分Swanson量表)。同时记录两组患者暂时性残疾的持续时间。在研究开始时,在肱骨肩胛骨综合征患者中检测到许多区域(最常见的是颈部区域,结构部分,以及胸部区域-内脏和结构部分)和局部(最常见的是肩关节和颞下颌关节)躯体功能障碍。主组治疗后,颈区(结构成分)、胸区(内脏和结构成分)、盆腔区(结构成分)病变的正动态变化有统计学意义(p< 0.05)。在对照组中,仅在胸区(内脏部分)疾病方面观察到显著的积极动态。两组在颈部和骨盆部位(结构部位)病变检出率上开始有显著差异(p< 0.05)。在主组中,肩关节和颞下颌关节紊乱有统计学意义(p< 0.05)的正动态,而在对照组中,仅在肩关节紊乱中检测到正动态。在研究开始时,两组患者的特征都是相当强烈的疼痛综合征(两组的平均得分都超过7分)。治疗后,两组患者均有显著(p< 0.05)的正动态变化,但主治疗组的结果更显著(p< 0.05),主治疗组为1,6±0.89分,对照组为2,7±0.86分。研究开始时的肩关节状态和日常生活活动的评分率相对较低,对照组和主要组的平均总分均不超过15分。治疗后,两组患者均有显著的正动态变化(p< 0.05),但主治疗组疗效更明显:主治疗组28.0±1.86分,对照组22.1±2.34分(p< 0.05)。主组患者的平均暂时残疾时间为8.1±1.07 d,对照组为15.0±1.84 d,两组比较差异有统计学意义(p< 0.05)。根据所获得的结果,我们可以假设,复杂治疗中包含的整骨矫正有助于患者更快地恢复,改善肩关节功能,缓解疼痛和增加日常生活活动,这使得我们可以推荐将其用于具有此类病理的患者。
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Substantiation of the possibility of using osteopathic correction in the complex treatment of patients with shoulder-shoulder pain syndrome
Introduction. Shoulder pain is one of the most common causes of disability in the population. Modern approaches to the treatment of shoulder pain syndrome give preference to the use of drug therapy. However, frequent side effects remain relevant the wider introduction of non-pharmacological methods of treatment. Osteopathy is one of such promising method. In this regard, the assessment of the effectiveness of osteopathic correction of patients with humeroscapular pain syndrome is in demand.The aim to substantiate the possibility of using osteopathic correction in the complex treatment of patients with shoulder pain syndrome.Materials and methods. The study involved 40 patients with shoulder pain syndrome. By the method of randomization using randomization envelopes, the 20 patients were included in the control group and the 20 patients in the main group. Participants of the control group received standard drug and physiotherapy treatment, participants of the main group additionally received a course of osteopathic correction. In both groups, before and after treatment, there were assessed the osteopathic status, the severity of pain syndrome by a 10-point visual analogue scale, the state (functioning) of the shoulder joints, and daily life activities by a 30-point Swanson scale. The duration of temporary disability in both groups was also recorded.Results. At the start of the study, a number of regional (most often — the neck region, structural component, and the chest region — visceral and structural component) and local (most often — the shoulder joint and temporomandibular joint) somatic dysfunctions were detected in patients with humeroscapular syndrome. After treatment in the main group, a statistically significant (p<0,05) positive dynamics was recorded in relation to disorders of the neck region (structural component), thoracic region (visceral and structural component), and pelvic region (structural component). In the control group, significant positive dynamics was observed only in relation to disorders of the thoracic region (visceral component). The groups began to differ significantly (p<0,05) by the disorders detection frequency of the neck and pelvis region (structural component). Also a statistically significant (p<0,05) positive dynamics was recorded in relation to disorders of the shoulder joint and temporomandibular joint in the main group, and in the control group it was detected only in relation to the shoulder joint disorders. At the start of the study, patients in both groups were characterized by a fairly intense pain syndrome (mean score over seven in both groups). After treatment, significant (p<0,05) positive dynamics was observed in both groups, but in the main group the result was significantly (p<0,05) more pronounced: 1,6±0,89 points in the main group versus 2,7±0,86 points in the control group. The shoulder joints state and the daily life activity at the study start moment were characterized by relatively low rates — the average total value was no more than 15 points in both the control and main groups. After the treatment, significant (p<0,05) positive dynamics was observed in both groups, but in the main group the result was more pronounced: 28,0±1,86 points in the main group versus 22,1±2,34 points in the control group (p<0,05). The average duration of temporary disability in days was 8,1±1,07 days in the main group and 15,0±1,84 days in the control group, the difference between the groups is statistically significant (p<0,05).Conclusion. Based on the obtained results, it can be assumed that osteopathic correction included in the complex treatment contributes to faster recovery of the patient, improvement of the shoulder joint functioning, pain relief and increased daily life activity, and this allows us to recommend it for use in patients with such pathology.
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