여성 만성견비통 환자에 대한 동서 협진 치료의 무작위 대조군 연구 Randomized Controlled Trial of East-West Collaborate Medical Treatment on Female Chronic Shoulder Pain Patients원문보기
목적 : 만성 견비통 환자에 대한 침 치료와 신경 차단술 병행 치료의 효과를 검증하고자 함. 방법 : 만성 견비통 환자 60명을 대상으로 동서병행치료군(EW group, n=20), 한방 침치료군(E group, n=20), 무처치 대조군(C group, n=20)으로 무작위 배정한 후 연구를 시작했다. 동서병행치료군은 먼저 견갑상 신경차단술, 견봉하 주사 및 압통점 국소 마취제를 맞은 후 5분간 휴식을 취한 후 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 주 2회 4주간 받았다. 한방 침치료군은 주 2회, 4주간 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 받았으며, 무처치 대조군은 4주간 특별한 처치를 받지 않았다. 모든 환자들은 일상생활에서 자가 운동을 실시하도록 지시 받았다. 치료 시작전과 치료 4주 후 Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), 및 환자의 주관적 통증 평가를 Visual Analogue Scale(VAS) 로 측정하여 모인 데이터 통계를 분석하였다. 결과 : 동서병행치료군 및 한방 침치료군 모두 CSA, SPADI 및 VAS 상에서 유의한 (p<0.05) 호전을 보였다, 동서병행치료군의 CSA, SPADI, VAS는 무처치 대조군과 비교하여 유의한 우의를 나타냈으며, 한방 침 치료군과 비교하여 VAS 에서 유의한 차이를 나타냈다. 결론 : 침치료와 신경차단술 병행 치료방법은 만성 견비통을 유의하게 호전시켰다. 무처치 대조군과의 차이는 3개의 측정 도구 모두에서 유의한 차이가 있었으며, 침치료만 받은 환자들과도 주관적 통증 척도에서 유의한 차이를 보였다.
목적 : 만성 견비통 환자에 대한 침 치료와 신경 차단술 병행 치료의 효과를 검증하고자 함. 방법 : 만성 견비통 환자 60명을 대상으로 동서병행치료군(EW group, n=20), 한방 침치료군(E group, n=20), 무처치 대조군(C group, n=20)으로 무작위 배정한 후 연구를 시작했다. 동서병행치료군은 먼저 견갑상 신경차단술, 견봉하 주사 및 압통점 국소 마취제를 맞은 후 5분간 휴식을 취한 후 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 주 2회 4주간 받았다. 한방 침치료군은 주 2회, 4주간 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 받았으며, 무처치 대조군은 4주간 특별한 처치를 받지 않았다. 모든 환자들은 일상생활에서 자가 운동을 실시하도록 지시 받았다. 치료 시작전과 치료 4주 후 Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), 및 환자의 주관적 통증 평가를 Visual Analogue Scale(VAS) 로 측정하여 모인 데이터 통계를 분석하였다. 결과 : 동서병행치료군 및 한방 침치료군 모두 CSA, SPADI 및 VAS 상에서 유의한 (p<0.05) 호전을 보였다, 동서병행치료군의 CSA, SPADI, VAS는 무처치 대조군과 비교하여 유의한 우의를 나타냈으며, 한방 침 치료군과 비교하여 VAS 에서 유의한 차이를 나타냈다. 결론 : 침치료와 신경차단술 병행 치료방법은 만성 견비통을 유의하게 호전시켰다. 무처치 대조군과의 차이는 3개의 측정 도구 모두에서 유의한 차이가 있었으며, 침치료만 받은 환자들과도 주관적 통증 척도에서 유의한 차이를 보였다.
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문제 정의
This study aims to observe the effect of acupuncture collaborated with nerve block treatment: on chronic shoulder patients and evaluate the treatment effectiveness by comparing with acupuncture treatment and no treatment. By doing so, we hope to provide essential data for future studies on East- West Collaborate medicine.
제안 방법
Evaluations were made before study and after 4 weeks from the baseline using Constant Shoulder Assessment(CSA)13), Shoulder Pain and Disability Index(SPADI)lh) and the patient's subjective pain scale was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared.
They were randomly assigned to East-West Collaboration treatment group(EW group, n二20), Eastern acupuncture treatment group(E group, n=20) and Control group(C group, n=20). Patients prescribed with anti inflammation medications and pain killers were asked to stop the medication and have a 1 week wash out period before they participated in this study.
The EW group first received suprascapular nerve block, subacromial injection and trigger point injection and after 5 minutes of rest received acupuncture treatment on LI15, TEu, GB21 and Master Dongs acupuncture points, Shin-gwan and Gyun- joong14), twice a week for 4 weeks. Patients were instructed to practice s인f exercise during their daily lives.
TEh, GB?i and Master Dong's acupuncture points, Shin-gwan and Gyun-joong141, twice a week for 4 weeks. The needles were inserted for 15 minutes after manual stimulation.
대상 데이터
60 chronic shoulder pain patients, working as call center agents at Korea Gas Cooperation, were recruited and studied by Kyung-Hee medical center. Patients were randomly assigned to East-West collaborate treatment group(EW group, n=20), Eastern treatment group(E group, n=20) and Control group (C group, n=20).
In this study, 60 chronic shoulder pain patients, working as call center agents at Korea Gas Cooperation, were recruited. This was because these call center agents engaged in computer labor more than 3 hours a day, which raises the possibilities of chronic shoulder pain without severe injuries to occur.
Stainless steel acupuncture needles measuring 0.3cm in diameter and 4cm in length, manufactured by Dongbang Acupuncture sited in Boryung, South Chungchong province, Korea, was used.
데이터처리
0 for windows was used for statistical analysis. The homogeneity of the three groups was verified by one way ANOVA and Chi square test. The significance of change before and after 4 weeks of treatment was analyzed with paired t-test.
The homogeneity of the three groups was verified by one way ANOVA and Chi square test. The significance of change before and after 4 weeks of treatment was analyzed with paired t-test. The significance of difference between the groups wer(? inspected by ANCOVA.
이론/모형
Assessment tools used were Constant Shoulder Assessment(CSA)1, ), Shoulder Pain and Disability Index(SPADD1(1), and Visual Analogue Scale(VAS). CSA is a simple clinical tool that combines func tional assessment of the shoulder with assessment of individual parameters, such as pain and daily activity.
Randomization was applied according to the ran domization code. And by separating the practitioner from the evaluator, single blind was successfully applied.
성능/효과
1. In treating chronic shoulder pain, 4 weeks of acupuncture treatment was significantly effective.
summarized in Table 1. There were no statis tically significant differences 거mong the three groups in terms of age, sex, and duration of symptoms (p>0.05). There were also no stati아ically significant differences among the three groups in respect of base line CSA, SPADI and VAS(P>0.
05)(Table 1). The change of CSA, SPADI and VAS within the EW group is as shown in Table 2. CSA improved from 48.39+5.36 to 61.11+5.80 after the 4 week treatment. SPADI decreased from 16.
2. In treating chronic shoulder pain, 4 weeks of nerve block injection collaborated with acupuncture treatment showed significant effect.
3. Collaborate treatment of acupuncture and nerve block injection was significantly better compared to untreated patients.
05). 4 weeks of acupuncture treatment showed significant improvement in CSA, SPADI and VAS(p<0.05).
4. Collaborate treatment of acupuncture and nerve block injection was significantly better in reducing pain compared to acupuncture treatment.
C'hronic shoulder pain p게ients showed significant improvement in CSA scores even after 4 weeks of no particular treatment(p<0.05). But, SPADI and VAS showed insignificant differences after 4 weeks of no treatment(p>0.
In treating chronic shoulder pain, 4 weeks of nerve block injection collaborated with acupuncture treatment showed significant improvement in CSA, SPADI and VAS(p<0.05). 4 weeks of acupuncture treatment showed significant improvement in CSA, SPADI and VAS(p<0.
05). SPADI scores before and after the 4 week study period improved significantly in EW group and E group. Statistics showed that the improvement of SPADI in EW group and E group were both significant compared to C group(p<0.
groups. Statistics showed that the improvement of CSA in EW group and E group were both significant compared to C group(p<0.05) but there was no difference between EW group and E group(p>0.05).
SPADI scores before and after the 4 week study period improved significantly in EW group and E group. Statistics showed that the improvement of SPADI in EW group and E group were both significant compared to C group(p<0.05) b나t there was no difference between EW group and E group (p>0.05).
The patients subjective pain scale recorded in the form of VAS showed significant improvement after the 4 week study period in EW group and E group. Statistics showed that the improvement of VAS in EW group was significant compared to bothe E group and C group(p<0.
후속연구
obtained. Further well-designed clinical trials of larger sample size in this area will be needed.
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