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研究生:陳睿潔
研究生(外文):Ruei-jie Chen
論文名稱:復健與非類固醇抗發炎藥物治療下肢關節扭傷及下背扭傷效果差異之探討
論文名稱(外文):Factors impact on effectiveness of rehabilitation therapy versus nonsteroidal antiinflammatory drugs in patients with sprain group in lower limb injury and lumbar sprain
指導教授:潘忠煜潘忠煜引用關係
指導教授(外文):Chung-Yu Pan
口試委員:陳南松劉復興
口試日期:2012-04-29
學位類別:碩士
校院名稱:東海大學
系所名稱:工業工程與經營資訊學系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:31
中文關鍵詞:足踝扭傷下背扭傷非類固醇抗發炎藥物復健治療
外文關鍵詞:Ankle sprainLumbar sprainNSAIDsRehabilitation therapy
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  • 被引用被引用:1
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  • 下載下載:26
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近年來我國民眾因知識水準日益提升,電視媒體的強力播送非類固醇抗發炎藥物的副作用(例如:腸胃道不適,長期服用影響腎功能),以至民眾到院就醫時,若非疼痛至影響日常生活作息,多數願以復健為主要治療方式。針對使用非類固醇抗發炎藥物或復健治療方式,在下肢關節扭傷及下背扭傷的急性及亞急性之治療效果,何者為優先使用?或混合搭配治療?本研究試圖在符合我國民眾的用藥習慣下,建立臨床路徑同時契合健保給付的規定。
本研究對象為2011年3月至2011年12月,到中部某區域醫院復健科門診及骨科門診,掛號醫治下肢關節扭傷(膝扭傷,踝扭傷,足部扭傷)及下背扭傷之病人,追蹤其兩個月之治療狀況。建議一開始應對下肢關節扭傷及下背扭傷的病人建議以PRICE 原則(保護、休息、冰敷、壓迫、及抬高患處),然後以非類固醇抗發炎藥物治療3-7天,一至兩週後以復健治療處理下肢關節扭傷及下背扭傷之病人,例如物理治療(冷療、熱敷、超音波治療,向量干擾波治療、經皮電刺激治療,關節被動性活動等),肌力訓練與本體感覺復健計畫,減輕病人繼續吃消炎止痛藥的心理負擔,以達病人恢復到受傷前工作狀態最大的治療效益。這樣的治療模式可做為臨床治療下肢關節扭傷及下背扭傷的參考。

Recently, people in Taiwan have a well knowledge of the side effects of nonsteroidal antiinflammatory drugs (NSAIDs) such as GI discomfort or renal dysfunction if long term used. When patients suffer from sprain and visit hospital, they would rather receive rehabilitation therapy than take medicine. To treat sprain group in lower limb injury and lumbar sprain whether NSAID drugs or rehabilitation therapy is better. Will combined therapy be better? This study tries to establish clinical pathway which correspondes with the rules of health insurance and the people behavior of taking medicine.
In this study, patients who visited rehabilitation department and orthopedic department in a community hospital at middle area in Taiwan from March of 2011 to December of 2011 becaused of sprain group in lower limb injury (knee sprain, ankle sprain, foot sprain) and lumbar sprain were included. In addition, the follow-up treatment is conducted for two months to every patient. It is suggested to apply the PRICE (protection, rest, ice, compression and elevation) method after injury immediately. Then a prescription of nonsteroidal antiinflammatory drugs (NSAIDs) for 3-7 days is issued. After that, patients may receive rehabilitation therapy (such as cryotherapy, hot packs, ultrasound diathermy, interferential current therapy, transcutaneous electrical nerve stimulation therapy and PROM exercise, muscle strengthening training, and proprioceptive training program). In order to relieve the stress of taking NSAIDs and resume the healthy condition before the patient got hurt, this protocol may be a choice for clinical treatment about sprain group in lower limb injury and lumbar sprain.

摘 要 i
ABSTRACT ii
誌謝 iii
目錄 iv
圖目錄 v
表目錄 vi
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 2
第二章 文獻探討 4
2.1 導致踝關節傷害發生之生理因素 4
2.2 踝關節扭傷的分類 5
2.3 治療 7
2.4 踝關節運動傷害之預防及復健之道 9
2.5 導致下背扭傷發生之原因診斷及治療 9
2.6 導致膝扭傷發生之原因及治療 10
第三章 研究方法 12
第四章 研究結果與討論 16
4.1 復健治療與藥物治療在各個部位扭傷之比較 16
4.2 復健治療與藥物治療在下肢關節扭傷與下背扭傷之比較 17
4.3 小結 27
第五章 結論 28
參考文獻 30

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