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研究生:湯明翰
研究生(外文):Tommy Tang
論文名稱:桑德式腰椎牽引與傳統式腰椎牽引對腰椎間盤突出症病患療效的比較
論文名稱(外文):The Comparison of Effects between Saunders’Traction and Traditional Traction inPatients with Lumbar Disc Herniation
指導教授:曹昭懿曹昭懿引用關係
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:物理治療學研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
中文關鍵詞:牽引腰椎間盤突出症下背痛
外文關鍵詞:TractionLow back painLumbar disc herniation
相關次數:
  • 被引用被引用:1
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本研究的目的是以桑德式腰椎牽引與傳統式腰椎牽引治療腰椎間盤突出症的病患,比較治療前後療效:疼痛、功能及機能損傷(impairment)的差異。本研究共有53 位受試者,隨機分派至桑德組與傳統組;其中桑德組25位,傳統組28位。所有病患在治療第1日、第4日、第7日、第14日、第21日及停止治療日一個月後均接受評估,評估內容包含VAS疼痛指數、Oswestry失能指數、直腿抬高測試、肌力測試、動作測試。研究期間病患流失率高,因此以分析至少完成四次評估之病患之療效為主。結果發現至少完成四次評估之二組病患在各項評估多無顯著差異,但在治療後兩組病患,在疼痛指數及失能指數上皆有進步。依性別、年齡(40歲)、急性或亞急性期開始接受治療及直腿抬高測試角度是否大於45°四個特性分別將病患分組後;在同特性之組內比較二種治療模式在各次評估時之VAS疼痛指數及Oswestry失能指數。發現在亞急性期開始接受治療及直腿抬高測試小於等於45°的病患中,第1次(第1日)評估時接受桑德式牽引治療病患之疼痛指數明顯較差(p<0.05),但自第2次評估起二種治療模式的病患狀況即無顯著差異;以性別及年齡40歲之區分的組內比較則無顯著差異。本研究結果顯示二種牽引模式都對腰椎間盤突出症病患的疼痛指數及失能指數的降低有所幫助,而桑德式牽引治療對於亞急性期求醫及在直腿抬高測試小於等於45°的病患可能有較佳降低疼痛的療效。未來的研究應針對桑德式牽引治療在整個腰椎間盤突出症病患病程中的所扮演的角色有更進一步的探討。

The purpose of this study was to compare the treatment effect in pain , function and impairment between Saunders’ traction and traditional traction for lumbar disc herniation (LDH) patients. Fifty-three LDH subjects were allocated to Saunders’ or traditional traction group randomly. All subjects were evaluated with VAS pain scores, Oswestry disability questionnaire, straight leg raising (SLR), muscle testing, and movement pain at 1st day, 4th day, 7th day, 14th day, 21st day in the treatment period and one month after DC day. Because of high drop rate, Mann-whitney test was used to compare the treatment effects in the patients who at least accepted 4-time evaluation. There was no significant difference in the VAS scores, Oswestry score and other tests between the two treatment groups who completed at least 14 days’ treatment. Patients in both groups showed progress in VAS sore and Oswestry score during the treatment course. Stratifying the patients with confounders[sex, age(cutting at 40 y/o), admission at acute or subacute stage and SLR(cutting at 45°)]; it showed significant difference between the two treatment groups in subacute patients and in patients whose SLR lower than 45˚. It revealed that the patients receiving treatment from subacute stage and patients whose SLR lower than 45° showed better pain relief effect by Saunders’ traction mode. Future research should be focused on the role of Saunders’ traction mode in the progress of lumbar disc herniation.

第一章 : 前言-----------------------------------------------------------------------------12
第一節 研究背景-------------------------------------------------------------12
第二節 研究目的-------------------------------------------------------------13
第三節 研究假設-------------------------------------------------------------13
第四節 使用名詞定義-------------------------------------------------------14
第二章 : 文獻回顧-----------------------------------------------------------------------16
第一節 腰椎間盤突出症的病理過程-------------------------------------16
第二節 牽引治療腰椎間盤突出症的機轉-------------------------------19
第三節 評估工具之信度與效度-------------------------------------------20
第三章 : 方法-----------------------------------------------------------------------------22
第一節 受試者與治療師----------------------------------------------------22
第二節 研究步驟與治療器材-------------------------------------------23
第三節 評估方法----------------------------------------------------------24
第四節 統計方法----------------------------------------------------------24
第四章 : 結果-----------------------------------------------------------------------------25
第五章 : 討論-----------------------------------------------------------------------------31
第一節 牽引的療效機轉-----------------------------------------31
第二節 影響療效之可能因子-----------------------------------31
第三節 研究限制--------------------------------------------------32
第四節 臨床應用與未來展望-----------------------------------35

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