健康教育管理模式对慢性非特异腰痛患者疗效的影响

doi:10.3969/j.issn.1006-9771.2018.01.020

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (1): 101-106.doi: 10.3969/j.issn.1006-9771.2018.01.020

健康教育管理模式对慢性非特异腰痛患者疗效的影响

吴琼, 潘钰, 徐泉, 萧演清, 杨绯, 李欣, 孙小花, 谢树, 陈固稳

清华大学附属北京清华长庚医院康复医学科,北京市 102218

收稿日期:2017-08-19 修回日期:2017-11-25 出版日期:2018-01-25 发布日期:2018-01-31
通讯作者: 潘钰;E-mail:panyu@btch.edu.cn。
作者简介:吴琼(1982-),女,满族,山西晋中市人,硕士,主治医师,主要研究方向：康复医学与理疗学。
基金资助:
北京清华长庚医院青年启动基金(No. 12016C1012)

Effects of Health Education Patterns on Chronic Nonspecific Low Back Pain: Three-month Follow-up

WU Qiong, PAN Yu, XU Quan, XIAO Yan-qing, YANG Fei, LI Xin, SUN Xiao-hua, XIE Shu, CHEN Gu-wen

Department of Physical Medicine and Rehabilitation, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China

Received:2017-08-19 Revised:2017-11-25 Published:2018-01-25 Online:2018-01-31
Contact: PAN Yu.E-mail:panyu@btch.edu.cn
Supported by:
Scientific Research Foundation for the Youth of Beijing Tsinghua Changgung Hospital (No.12016C1012)

摘要/Abstract

摘要： 目的观察不同健康教育管理模式对慢性非特异腰痛患者疗效保持的影响。方法选择2016年9月至2017年4月康复训练后症状稳定的慢性非特异腰痛患者75例,分为对照组(n=45)和腰痛学校组(n=30)。腰痛学校组以集体授课形式介绍腰椎生理解剖知识、人体工程学、不良生活姿势以及家庭功能锻炼方法,每周1次,共4次。对照组发放包含以上内容的宣教手册进行传统健康宣教。门诊复诊、电话随访及微信随访获得患者入组时、随访1个月、随访3个月的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腰痛复发次数、简明健康调查问卷(SF-36)评分。结果两组VAS评分均随时间推移逐渐增加,但腰痛学校组明显低于对照组(Z>2.645, P<0.01)。腰痛学校组3个月内腰痛复发次数低于对照组(Z=-2.082, P<0.05)。腰痛学校组ODI评分在随访3个月时高于对照组(Z=2.265, P<0.05);腰痛学校组SF-36躯体疼痛评分在随访1个月、3个月时高于对照组(t>2.273, P<0.05)。结论腰痛学校健康教育模式在维持慢性非特异腰痛患者的临床疗效、减少复发、改善患者功能状态及生活质量方面,较传统宣教模式有更积极的影响。

关键词: 慢性非特异腰痛, 健康教育, 腰痛学校, 随访

Abstract: Objective To observe the effects of different health education patterns on chronic nonspecific low back pain (CNLBP).Methods From September, 2016 to April, 2017, 75 patients with CNLBP after rehabilitation were randomly divided into control group (n=45) and Back School group (n=30). The Back School group received group teaching including physiological and anatomy of lumbar spine, ergonomics, healthy posture and function exercise, once a week for four weeks. While the control group received the booklets including the same contents. They were self-assessed with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and the 36-item Short Form (SF-36) before education, and one and three months of follow-up in clinics, or with call back services and Wechat. The recurrence frequency was recorded.Results The score of VAS increased in both groups in the follow-up, but increased less in the Back School group (Z>2.645, P<0.01). The recurrence frequency was less in the Back School group (Z=-2.082, P<0.05), with more ODI score (Z=2.265, P<0.05) after three months of follow-up. The bodily pain score of SF-36 was more in the Back School group after one and three months of follow-up (t>2.273, P<0.05).Conclusion Health education with Back School may benefit to maintain the curative effects and function, reduce recurrence, and improve the quality of life of CNLBP patients.

Key words: chronic nonspecific low back pain, health education, Back School, follow-up

中图分类号:

R681.5

吴琼, 潘钰, 徐泉, 萧演清, 杨绯, 李欣, 孙小花, 谢树, 陈固稳. 健康教育管理模式对慢性非特异腰痛患者疗效的影响[J]. 《中国康复理论与实践》, 2018, 24(1): 101-106.

WU Qiong, PAN Yu, XU Quan, XIAO Yan-qing, YANG Fei, LI Xin, SUN Xiao-hua, XIE Shu, CHEN Gu-wen. Effects of Health Education Patterns on Chronic Nonspecific Low Back Pain: Three-month Follow-up[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(1): 101-106.

参考文献

[1] 岳寿伟. 腰痛的评估与康复治疗进展[J]. 中国康复医学杂志, 2017, 32(2): 136-139.
[2] Jöud A, Petersson IF, Englund M, et al. Low back pain: epidemiology of consultations [J]. Arthritis Care Res (Hoboken), 2012, 64(7): 1084-1088.
[3] Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society [J]. Ann Intern Med, 2007, 147(7): 478-491.
[4] 范顺武,赵兴,方向前. 下腰痛的复发与危险因素的预防[J]. 全科医学临床与教育, 2010, 8(2): 121-124.
[5] Furunes H, Hellum C, Brox JI, et al. Lumbar total disc replacement: predictors for long-term outcome [J]. Eur Spine J, 2017. [Epub ahead of print]. https://doi.org/10.1007/s00586-017-5375-1.
[6] 邱伟,吕莉,张卫红,等. 健康教育处方在骨科患者健康教育中的应用[J]. 护士进修杂志, 2013, 28(12): 1105-1107.
[7] Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients [J]. J Exerc Rehabil, 2017, 13(4): 486-490.
[8] Globe G, Farabaugh RJ, Hawk C, et al. Clinical Practice Guideline: Chiropractic Care for Low Back Pain [J]. J Manipulative Physiol Ther, 2016, 39(1): 1-22.
[9] Delitto A, George SZ, Dillen LV, et al. Low Back Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association [J]. J Orthop Sports Phys Ther, 2012, 42(4): A1-A57.
[10] Patel AA, Donegan D, Albert T. The 36-item short form [J]. J Am Acad Orthop Surg, 2007, 15(2): 126-134.
[11] 程继伟,王洪伟,郑文杰,等. 慢性下腰痛疗效评价方法的应用现状[J]. 中国修复重建外科杂志, 2014, 28(1): 119-122.
[12] Jacobs WC, Gaag NA, Kruyt MC, et al. Total disc replacementfor chronic discogenic low back pain: a cochrane review [J]. Spine (Phila Pa 1976), 2013, 38(1): 24-36.
[13] Yu Y, Liu W, Song D, et al. Diagnosis of discogenic low back pain in patients with probable symptoms but negative discography [J]. Arch Orthop Trauma Surg, 2013, 132(5): 627-632.
[14] Phan NQ, Blome C, Fritz F, et al. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus [J]. Acta Derm Venereol, 2012, 92(5): 502-507.
[15] Furtado RN, Ribeiro LH, Abdo BA, et al. Nonspecific low back pain in young adults: associated risk factors [J]. Rev Bras Reumatol, 2014, 54(5): 371-377.
[16] Childs JD, Wu SS, Teyhen DS, et al. Prevention of low back pain in the military cluster randomized trial: effects of brief psychosocial education on total and low back pain-related health care costs [J]. Spine J, 2014, 14(4): 571-583.
[17] Wessels T, van Tulder M, Sigl T, et al. What predicts outcome in non-operative treatments of chronic low back pain? A systematic review [J]. Eur Spine J, 2006, 15(11): 1633-1644.
[18] Hulla R, Gatchel RJ, Liegey-Dougall A. Biopsychosocial measures related to chronic low back pain postural control in older adults [J]. Healthcare (Basel), 2017, 5(4): 74.
[19] Amescua-Garcia C, Colimon F, Guerrero C, et al. Most Relevant Neuropathic Pain Treatment and Chronic Low Back Pain Management Guidelines: A Change Pain Latin America Advisory Panel Consensus [J]. Pain Med, 2017. [Epub ahead of print]. doi:10.1093/pm/pnx198.
[20] Stanton TR, Latimer J, Maher CG, et al. Definitions of recurrence of an episode of low back pain: a systematic review [J]. Spine (Phila Pa 1976), 2009, 34(9): E316-E322.
[21] de Vet HC, Heymans MW, Dunn KM, et al. Episodes of low back pain: a proposal for uniform definitions to be used in research [J]. Spine (Phila Pa 1976), 2002, 27(21): 2409-2416.
[22] Machado GC, Pinheiro MB, Lee H, et al. Smartphone APPs for the self-management of low back pain: A systematic review [J]. Best Pract Res Clin Rheumatol, 2016, 30(6): 1098-1109.
[23] Pawar SG, Ramani PS, Prasad A, et al. Software version of Roland Morris Disability questionnaire for outcome assessment in low back pain [J]. Neurol Res, 2017, 39(4): 1-6.
[24] Shirotsuki K, Nonaka Y, Takano J, et al. Brief internet-based cognitive behavior therapy program with a supplement drink improved anxiety and somatic symptoms in Japanese workers [J]. Biopsychosoc Med, 2017, 11(1): 25-32.

健康教育管理模式对慢性非特异腰痛患者疗效的影响

Effects of Health Education Patterns on Chronic Nonspecific Low Back Pain: Three-month Follow-up

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