全膝关节表面置换早期推拿的疗效评价  

Therapeutic effect of early Tuina rehabilitation treatment after total knee arthroplasty

作　　者：王念宏[1] 严隽陶[2] 孙武权[2] 胡永善[1] 夏军[1] 魏礼成[1] 吴毅[1] 贾杰[1] 欧阳桂林 何勇 郭艳明 许洁 

机构地区：[1]复旦大学附属华山医院康复医学科,上海市200040 [2]上海中医药大学附属岳阳中西医结合医院,上海市200437 [3]上海市长宁区光华中西医结合医院,上海市200050

出　　处：《中国组织工程研究》2013年第9期1543-1548,共6页Chinese Journal of Tissue Engineering Research

基　　金：上海市科学技术委员会中药现代化专项(No.09dZ1977100;10DZ1973900);上海市重点学科建设项目(No.T0302)~~

摘　　要：背景:研究推拿对类风湿性关节炎患者全膝关节表面置换后康复的疗效、探求推拿康复治疗的机制。目的:观察类风湿性关节炎患者全膝关节表面置换后早期推拿综合康复的临床疗效,为优选康复方案提供参考。方法:将66例接受全膝关节表面置换的类风湿性关节炎患者以1∶1的比例分为对照组和推拿组,每组33例,置换后对照组行持续被动运动训练,推拿组行持续被动运动结合推拿康复。通过HSS评分、SF-36健康问卷评分观察推拿综合康复方法对患者疗效的影响。结果与结论:置换后3个月HSS评分组间比较:功能(P=0.020)、肌力(P=0.002)、稳定性(P=0.011)和总分(P=0.019),均显著提高,与治疗前比较差异均有显著性意义(P<0.05)。置换后3个月SF-36评分组间比较:精神健康(P=0.003)、总体健康(P=0.008)评分均显著提高,与治疗前比较差异有显著性意义(P<0.05)。说明推拿早期干预可促进类风湿性关节炎患者全膝关节表面置换后的功能恢复、改善了置换后膝关节的肌力、增加了膝关节稳定性、提高了精神健康和总体健康水平。BACKGROUND： The present study investigated the efficacy of Tuina rehabilitation on the patients with rheumatoid arthritis after total knee arthroplasty and the mechanism underlying Tuina rehabilitation. OBJECTIVE： To observe the clinical effect of early Tuina comprehensive rehabilitation therapy on rheumatoid arthritis patients after total knee arthroplasty, in order to provide some objective evidences for clinical rehabilitation treatment. METHODS： Sixty-six rheumatoid arthritis patients after total knee arthroplasty were equally divided into two groups control group and Tuina group. The patients in the control group underwent continuous passive motion training after replacement, and the patients in the Tuina group underwent continuous passive motion training combined with Tuina rehabilitation. The effect of Tuina comprehensive rehabilitation was observed through Hospital for Special Surgery system and 36-Item Short-Form Health Survey. RESULTS AND CONCLUSION： Comparison of the Hospital for Special Surgery score among groups at 3 months after replacement found that the function （/==-0.020）, muscle strength （P=0.020）, stability （P=0.011 ） and total scores （P=0.019） were improved, and there were significant differences when compared with those before treatment （P 〈 0.05）. Comparison of the 36-Item Short-Form Health Survey scores among groups at 3 months after replacement found that the emotional health score （P=0.003） and total health score （P=0.008） were significantly improved, and there were significant differences when compared with those before treatment （P 〈 0.05）. Early Tuina rehabilitation could facilitate function restoration and improve strength, stability, emotional health and total health for the rheumatoid arthritis patients after total knee arthroplasty.

关 键 词：骨关节植入物 人工假体 类风湿性关节炎 全膝关节置换 推拿手法 推拿功法 康复 肌力 精神健康 疼痛 关节活动度 稳定性 省级基金 

分 类 号：R318[医药卫生—生物医学工程]