运动疗法对类风湿关节炎患者关节功能的影响

发布时间：2018-05-13 12:49

本文选题：关节炎 + 类风湿　；参考：《浙江大学》2015年硕士论文

【摘要】：目的观察运动干预期间类风湿关节炎(RA)患者关节功能状态、健康状况评估问卷(HAQ)评分、疾病活动度等指标的变化,为运动疗法提供理论依据,同时为指导RA患者开展专科康复提供基础。方法 1.选取60例来自浙江大学医学院附属第一医院门诊和住院的RA患者,随机分成治疗组和对照组。专业康复医生和治疗组RA患者采取“一对一”康复模式进行为期3个月的运动康复治疗。 2.观察RA患者治疗前后的疾病活动指标、双手肌力、四肢主动关节活动度(AROM)和HAQ评分。 3.分析RA患者疾病活动指标及关节功能变化与生活质量的关系。结果 1.3个月后治疗组和对照组RA患者的晨僵时间、患者总体评估(PGA)、28个关节压痛计数(TJC28)、28个关节肿胀计数(SJC28)、血沉(ESR)、C反应蛋白(CRP)、28个关节疾病活动度评分(DAS28)、双手平均握力均有改善,差异有统计学意义；治疗组患者的双手平均握力、PGA和DAS28评分比对照组患者改善更显著,差异有统计学意义。 2.治疗组RA患者AROM有不同程度改善,部分关节改善程度有统计学意义。对照组RA患者左侧腕关节AROM的背伸和桡偏在治疗后变小,其中桡偏治疗前后差异有统计学意义；对照组患者其余AROM虽有好转,但差异无统计学意义。 3.两组RA患者治疗前后HAQ总评分改善显著,且治疗组患者的改善程度优于对照组患者,差异有统计学意义。治疗组RA患者HAQ评分中的进食、行走、抓握和活动这四个单项测评,3个月后改善差异有统计学意义；相比之下,对照组RA患者的单项测评改善差异则无统计学意义。结论 1.药物能控制RA病情,但随着病程进展,缺乏功能锻炼的RA患者会出现AROM下降。 2.在药物有效控制RA病情的基础上结合运动疗法,能有效改善患者的肌力和AROM。 3.随着四肢关节功能的恢复,RA患者生活质量提高,自我状况评估改善。
[Abstract]:Purpose To observe the changes of joint function, health assessment questionnaire (HAQ) score and disease activity in patients with rheumatoid arthritis (RA) during exercise intervention, and to provide theoretical basis for exercise therapy. At the same time, to guide RA patients to carry out specialized rehabilitation to provide the basis. Method 1. Sixty RA patients from the first affiliated Hospital of Zhejiang University Medical College were randomly divided into treatment group and control group. Professional rehabilitation doctors and RA patients in the treatment group were treated with one-to-one rehabilitation mode for 3 months. 2. The index of disease activity, the muscle strength of hands, the range of active joint motion of limbs and the HAQ score were observed before and after treatment in RA patients. 3. Objective: to analyze the relationship between disease activity index, joint function and quality of life in RA patients. Result 1.After 3 months, the morning stiffness time of RA patients in treatment group and control group, the overall assessment of PGAA, TJC28, SJC28, ESR, DAS28 and DAS28, the average grip strength of both hands were improved. The average grip strength and DAS28 scores in the treatment group were significantly improved than those in the control group. 2. In the treatment group, AROM of RA patients was improved to some extent, and the degree of partial joint improvement was statistically significant. In the control group, the dorsal extension and radial deviation of AROM in the left wrist became smaller after treatment, and the difference between the two groups before and after radial deviation was statistically significant, while the other AROM in the control group was improved, but the difference was not statistically significant. 3. The total score of HAQ was significantly improved in the two groups before and after treatment, and the improvement degree of the treatment group was better than that of the control group, and the difference was statistically significant. In the HAQ score of RA patients in the treatment group, there were significant differences in food intake, walking, grip and activity after 3 months, but there was no significant difference between the control group and the control group. Conclusion 1. Drugs can control the condition of RA, but with the progression of the disease, the AROM of RA patients with lack of functional exercise will decrease. 2. On the basis of effective control of RA, combined with exercise therapy, the patient's muscle strength and AROM can be effectively improved. 3. With the recovery of joint function in extremities, the quality of life and self-assessment of RA patients improved.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.22

【参考文献】