系統推拿對肩周炎患者之效益

南華大學機構典藏系統 > 科技學院 > 自然生物科技學系(自然療癒碩士班) > 博碩士論文-自然療癒碩士班 > Item 987654321/29107

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题名:	系統推拿對肩周炎患者之效益
其它题名:	Efficacy of Systematic Tuina in Patients with Adhesive Capsulitis
作者:	黃謙騤 HUANG, CHIEN-KUEI
貢獻者:	自然生物科技學系自然療癒碩士班林群智 LIN, CHUN-CHIH
关键词:	肩周炎;冷凍肩;系統推拿;疼痛視覺類比量表;關節活動度評量表;按摩 Periarthritis of shoulder;Frozen Shoulder;Systematic Tuina;Visual Analogue Scale (VAS);range of motion(ROM);Massage
日期:	2022
上传时间:	2022-09-01 14:00:45 (UTC+8)
摘要:	背景及目的：肩周炎，俗稱五十肩，為一種自發性、漸進性的肩關節周圍炎，常導致病患肩關節活動障礙及疼痛，大為影響其生活品質。在肩周炎治療方面，國內一般民衆較常使用的療法爲藥劑治療、復建療法以及神經阻斷術，而部分民衆亦會通過中醫的針灸、推拿等進行相關介入，也有部分民衆同時接受中醫與西醫的治療，但因爲兩者屬不同科，民衆需要分別到不同的診間進行治療，耗費大量時間。先前的研究曾採用結合了西醫關節鬆動法以及中醫推拿療法的系統推拿法協助無數民衆恢復健康，故本研究旨在透過系統推拿方式進行撥、推、按、壓、揉等手法系統性地對肌筋膜、淋巴結、血管和肌肉進行推拿，以改善患者之肩周炎及提高民衆的生活品質，並探討其對肌筋膜粘連和鬆懈的影響。　　研究設計與方法：本研究主要招募37位年齡介於35至54歲自覺或患有肩周炎三個月以上患者，執行兩週各一次的介入，並於其中執行介入前以及介入後進行評估個人疼痛感受的VAS視覺類比量表以及ROM關節活動度評量量表，全程共需評量4次。在研究結束後使用SPSS20.0進行次數分配表以及成對t檢定上的分析，從中探討系統推拿方式介入法的有效。　　結果與結論：研究結果顯示在兩次的介入下受試者的疼痛感受從7分左右「非常痛」下降至1分左右的「輕微疼痛」，ROM關節活動度評量部分，評量指標包括屈曲、伸直、外展、水平外展、水平內收、外旋轉以及內旋轉在改善方面皆達到顯著性差異，其持效性也獲得證明，結果證明，系統推拿方式能有效改善肩周炎。系統推拿的主要機制在於降低交感神經系統的活性，促進內皮細胞釋放一氧化氮，減少前列腺素的分泌，從而刺激血管擴張，促進血液循環，清除代謝物（如乳酸），減輕受損部位炎症反應，從而有效地改善肩周炎。　　BACKGROUND & OBJECTIVE: Periarthritis of shoulder is considered as a progressive periarthritis of shoulder, which often leads to shoulder mobility disorders and pain. It greatly affects a person’s quality of life. Drug treatment, rehabilitation therapy and the Plexus Block Pain Therapy are commonly used for Taiwanese to treat the frozen shoulders. Some of the patients may choose acupuncture therapy, massage therapy in Chinese medicine, or both of them. In Taiwan, Western medicine and Chinese medicine belong to different departments, which takes the patients lots of time going through different departments. Previous studies utilized Remedial Massage which combines Orthopedic Joint Mobilization, Manipulation in western medicine and massage therapy from Chinese medicine to rehabilitate a lot of patients. Accordingly, this study aimed to improve the frozen shoulders and the quality of life of the community, via a systematic tuina on myofascial, lymphatic nodes, blood vessels and muscles by toggling, naprapathy, pressing and kneading; The effect on the adhesion of the myofascial and muscle slack were also investigated.　　DESIGN & METHODS: In this study, 37 patients aged 35 to 54 years and were consciously suffered from frozen shoulders for more than 3 months were recruited to perform treatment once per week for two weeks. The visual analogue scale(VAS) was used to evaluate personal pain perception and the range of motion(ROM) scale were used to evaluate personal`s shoulder range of motion before and after treatment. At the end of the study, paired T-test was used to analyze the difference by SPSS 20.0, to determine efficacy of the Remedial Massage.　　CONCLUSIONS: The results of the study showed that the subjects’ pain perception decreased from about 7 points defined as “very painful” to about 1 point as “slight pain” after the two treatments. In the evaluation of ROM joint range of motion, the indicators, including Shoulder Flexion, Shoulder Extension, Shoulder Abduction, Shoulder Horizontal Abduction, Shoulder Horizontal Abduction, Shoulder External Rotation and Shoulder Internal Rotation, revealed significant differences in improvement and the effective persistency. From the results, the systematic tuina can effectively improved the periarthritis of shoulder. The main mechanism of the systematic tuina is proposed by decreasing the activity of sympathetic system, the promoting the release of the nitric oxide from endothelial cells, decreasing the secretion of prostaglandin, and thus stimulating vasodilation, promoting blood circulation and removal of metabolic waste (such as lactic acid) as well as reducing inflammation of the suffered region, which effectively achieved the improvement of Periarthritis of shoulder.
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