家庭适宜技术指导对社区颈椎病患者的管理效果评价  

Effect of Family Appropriate Technical Guidance in Patients with Cervical Spondylosis in Community

作　　者：李晖[1] 张惠琴[2] 汪志良[2] 江彬[2] 侯小琦 张复亮 唐琼[2] 谢伟[2] 韩捷[2] 冯广成 王炎[2] 杨新文[2] 朱远熔[2] 曾国庆[2] 

机构地区：[1]上海市徐汇区田林街道社区卫生服务中心,200233 [2]上海市徐汇区徐家汇街道社区卫生服务中心

出　　处：《中国全科医学》2013年第35期4179-4181,4186,共4页Chinese General Practice

基　　金：上海市徐汇区科委资助项目(SHxh201028);上海市徐汇区卫生局资助项目(XHTSXM1010)

摘　　要：目的评价家庭适宜技术指导对社区颈椎病患者的管理效果,探索颈椎病社区康复新模式。方法选择2011—2012年上海市徐汇区徐家汇街道社区卫生服务中心收治的颈椎病患者81例,按患者就诊顺序分为对照组41例和管理组40例。两组患者均采用统一的规范颈椎病推拿手法,管理组在此基础上同步实施家庭适宜技术指导,持续时间为3个月。比较两组患者管理前后颈部伤残(NDI)指数及症状自评量表(SCL-90量表)得分,随访患者复发情况并进行效益成本评估。结果治疗前,两组患者NDI指数及SCL-90量表抑郁因子得分、焦虑因子得分、躯体化因子得分比较,差异均无统计学意义(P>0.05);治疗后,管理组NDI指数及SCL-90量表焦虑因子得分、躯体化因子得分均低于对照组(P<0.05)。管理组复发率低于对照组,推拿手法治疗次数少于对照组(P<0.05)。结论家庭适宜技术指导对社区颈椎病患者的管理效果良好,有助于提高患者生活质量,是一种值得推广应用的颈椎病社区康复新模式。Objective To evaluate the effect of family appropriate technical guidance in patients with cervical spondy- losis in community, in order to establish a new model of rehabilitation in community. Methods A total of 81 patients with cervi- cal spondylosis treated in Xujiahui Street Community Health Center were reeuited in this study. And they were randomly divided into the management group （n = 40） and the control group （n =41 ）. The control group received the standard traditional mas- sage, while besides the traditional massage the management group also received standardized family appropriate technical guid- ance for rehabilitation for three months. The neck disability index （NDI）, the score of Symptom Checklist -90 （SCL- 90 ）, and the recurrence during the follow - up were collected, and the social economic benefits was evaluated before and after the treatment. Results Before the treatment, there was no significant differenee in NDI and the scores of depression subscale, anx- iety subscale, and somatization subseale of SCL - 90 between the two groups （P 〉 0.05 ）. However, after the treatment, NDI, the scores of anxiety subscale, and the scores of somatization subseale of SCL -90 were significantly lower in the management group than in the control group （P 〈 0. 05）. The recurrence rate and the numbers of massage were also significantly lower in the management group than in the control group （ P 〈 0. 05 ）. Conclusion In the new model of rehabilitation in community, the family appropriate technical guidance could enhance the recovery of eervical spondylosis and improve the quality of life of the pa- tients.

关 键 词：社区卫生服务 颈椎病 康复 疾病管理 推拿 

分 类 号：R493.2[医药卫生—康复医学] R681.531[医药卫生—临床医学]