康复治疗对老年糖尿病并发肩周炎病人代谢控制的影响

EFFECTS OF REHABILITATION THERAPY ON METABOLIC CONTROL IN ELDERLY DIABETIC PATIENTS WITH PERIARTHRITIS OF SHOULDER

①目的 观察康复治疗对老年糖尿病并发肩周炎病人代谢控制的影响。②方法 30例老年糖尿病并发肩周炎病人首先经内分泌科常规治疗 2个月 ,在此基础上加肩周炎康复治疗。观察康复治疗后 2、4、6个月肩关节活动度及血压、空腹及餐后 2h血糖、糖基化血红蛋白 (HbAlc)、血三酰甘油、血胆固醇水平的变化。③结果康复治疗 2个月病人肩关节活动度明显改善 ,治疗 4个月肩关节前屈、外展、内旋功能接近正常水平 ,治疗 6个月病人肩关节前屈、内旋、外旋功能基本正常 ,外展、后伸功能接近正常 (F =6 .75～ 1 6 .2 7,q =2 .6 5～ 6 .82 ,P <0 .0 5 )。肩周炎康复治疗 2个月 ,病人收缩压和舒张压有升高趋势 ,治疗 4个月后收缩压和舒张压均下降 ,治疗 6个月后 ,收缩压降至正常 ,舒张压变化不明显 ;康复治疗 2个月后空腹血糖、餐后 2h血糖、三酰甘油、胆固醇水平开始出现明显降低 ,治疗 6个月上述指标接近正常 (F =6 .38～ 9.35 ,q =2 .36～ 5 .1 6 ,P <0 .0 5 )。 ④结论 康复治疗不但减轻老年糖尿病并发肩周炎病人的肩痛、改善肩关节活动度 。

Objective To investigate the effect of rehabilitation therapy on the control of metabolism in elderly diabetic patients with periarthritis of shoulder. Methods Thirty patients of this kind were treated by endocrinologists first for two months, and then rehabilitation therapy of periarthritis of shoulder was given. Blood pressure, blood sugar, HbA1c, TG and TC were measured after two, four and six months of the treatment. Results The motion of the shoulders was significantly improved after two months of the combined treatment. The flexion and rotation of the joint returned to almost normal in four months and, in six months, fully recovered ( F=6.75-16.27, q=2.65-6.82, P <0.05). After six months of rehabilitation, the systolic pressure returned to normal, while diastolic change was little. The levels of blood sugar, HbA1c, TG and TC were significantly reduced or nearly normal during two to six months of the therapy( F=6.38-9.35,q=2.36-5.16,P <0.05). Conclusion Rehabilitation therapy improves not only pain and mobilization of the shoulder, but also the metabolic disturbance in elderly patients with diabetes accompanying periarthritis of shoulder.