肌肉能量技术治疗强直性脊柱炎活动期功能障碍疗效观察

Effect of Muscle Energy Technology on Motor Dysfunction in Patients with Active Ankylosing Spondylitis

目的:应用肌肉能量技术(MET)治疗强直性脊柱炎(AS),观察MET对AS活动期的疼痛、关节活动度、肌力、炎症指标的改善情况,寻求针对AS患者功能障碍的可行的物理治疗方法。方法:将AS活动期患者24例按照随机数字表分为实验组10例和对照组14例,2组均采用常规药物(塞来昔布)治疗,实验组同时接受MET治疗。针对AS不同的功能障碍点,以疼痛VAS评分为依据,分别运用MET技术中的多种治疗方法进行综合治疗,共治疗3个月。比较治疗前后2组的疼痛(VAS)、关节活动度(ROM)、肌力(MMT)、强直性脊柱炎Schober试验、Bath强直性脊柱炎病情活动性指数(BASDAI)、Bath强直性脊柱炎功能性指数(BASFI)及红细胞沉降率(ESR)、C反应蛋白(CRP)水平。结果 :(1)与治疗前比较,实验组疼痛VAS、BASFI、BASDAI、ESR、CRP明显降低(P<0.05),肌力、颈椎ROM、胸椎ROM、腰椎ROM、Schober评分明显升高(P<0.05);对照组疼痛VAS、ESR明显降低(P<0.05)。(2)与对照组比较,实验组治疗后疼痛VAS、BASFI、BASDAI明显降低(P<0.05),肌力、腰椎ROM、Schober评分明显升高(P<0.05)。结论 :肌肉能量技术可应用于活动期的强直性脊柱炎患者,对疼痛、腰椎关节活动度、肌力、强直性脊柱炎功能指标的改善具有明显的疗效。

Objective：To observe the effect of muscle energy technology（MET） on the pain,range of motion,muscle strength and inflammatory indicators in patients with active ankylosing spondylitis（AS）,and to seek an effective physical therapy to improve dysfunction in AS patients. Methods：Twenty-four patients with active AS confirmed by the rheumatologists were randomized into experimental group（n=10） and control group（n=14）. The experimental group accepted both conventional drug treatment（celecoxib） and MET therapy,and the control group accepted only celecoxib. The treatment lasted for three months in both groups. The MET therapy adopted various techniques targeting at different dysfunctional points that identified by visual analog scale（VAS） score. A number of measures were evaluated before and after the treatment,including pain assessment by VAS,rang of motion（ROM）,manual muscle testing（MMT）,ankylosing spondylitis schober test,bath AS disease activity index（BASDAI）,bath AS functional index（BASFI）,erythrocyte sedimentation rate（ESR） and c-reactive protein（CRP） level. Results：After the treatment,the VAS,BASFI,BASDAI,ESR,and CRP in experimental group were decreased significantly,while muscle strength,cervical ROM,thoracic ROM,lumbar ROM and Schober score were increased significantly（P〈0.05）. The VAS and ESR in control group were decreased significantly（P〈0.05）.Compared with the control group,the pain VAS,BASFI and BASDAI scores were decreased significantly,muscle strength,lumbar ROM and Schober score were increased significantly（P〈0.05）. Conclusion：MET is an effective therapy in reducing pain and improving the lumbar joint mobility,muscle strength and AS functional index for AS patients at the active stage.