A
Danh gia tac dung giam dau cua phuong phap dien cham liet hop tap dudng sinh tren benh nhan
dau cd gay do thoai hoa dot song cd
EVALUATE THE ANALGESIC EFFECT OF ACUPUNCTURE METHOD COMBINED WITH NOURISHING ON PATIENTS
WITH NECKPAIN DUE TO CERVICAL SPONDYLOSIS
Tong Quang Huy, Le Thj Kim Dung
Hoc vien Y D u o c hoc co truyen Viet N a m
TOM TAT
Nghiin cHu 4udc tiin hdnh nham mgc tiiu ddnhgid tdc dtxnggidm dau cuaphudngphdp diin chdm kit hdp tap dudng sinh dHu tri dau cdgdy do thodi hda dot song co. Nghien citu dtidc tien hdnh tren 60 benh nhdn dau cSgdy do thodt hda ddtsdngco, nhdm nghiin ciiugdm 30 henh nhdn dUdc diiu tri bdngdiin chdm 30phut/ldn X1 Idn/ngdy x 30 ngdy kethdp tdp dudngsinh vdt liiu trinh 30phiit/ldn x 1 lan/ngdy x 30 ngdy. Nhom chiing gdm 30 binh nhdn dUdc diiu tri ddn thudn bang dien chdm vdi lieu trinh: 30phiit/ldn x 1 lan/ngdy x 30 ngdy.
Kit qud nghien ciiu cho thdy thay ddi mtic dd dau theo thang dtim VAS d nhom nghiin cHu sau 30 ngdy diiu tri la khdng cdn binh nhdn d miic dd rdt dau, binh nhdn dau viia cdn 6,7%, benh nhdn dau it Id 53,3% vd binh nhdn d mUc do khdng dau Id 40%. Sau 30 ngdy diiu tri dNNC mile do dau theo thang diim VAS la 1,17±1,02 diim, trude dii'u tn la 6,47+1,45 diim. ONC miic dd dau theo thang diim VAS Id 1,83±0,98 diim, tnldc diiu tri Id 6,4+1,54 diim. Sukhdc biit giita hai nhdm cdy nghia thdngke vdip<0,0S.
SUMMARY
The study was conducted to evaluate the analgesic effect of electro-acupuncture method combined with nursing practice to treat neck pain caused by cervical spondylosis. The study was conducted on 60 patients with neck pain due to cervical spondylosis, the research group consisting of 30patients were treated by electro-acupuncture every 30 minutes x 1 time / day x 30 days combined with nursing practice every 30 minutes / time x 1 time / day x 30 days. The control ^oup consisted of 30 patients treated only electro-acupuncture method with the course: 30 minutes / time x 1 time / day x 30 days. The results showed that the change in pain level according to VAS scale after 30 days of treatment and no longer had severe pain patients, moderate pain patients sUllhad 6.7%, patients had less pain of 53.3% and patients at painless levels were 40%. After 30 days of treatment in the study group, the
Ngay nhan bai. 9/1/2019 Ngayphdnbien 11/1/2019 Ngay chdp nhan dang • 11/1/20! 9
TAP CHI Y DUOC C 6 TRUYEN VIET NAM
BAI NGHIEN CIJU •
pain level accordingto VAS scale is 1.17 ±1.02points, before treatment is 6.47± 1.45points. In the controlgroup, the pain level according to VAS scale is 1.83 ± 0.98 points, before treatment is 6.4 ± 1.54 points. The difference between the two groups was statistically significant with p <0.05.
DAT VANDE
Thoai hoa dot song c6 la benh Iy cot song man tinh, dau va bien dang, khong c6 bieu hien viem.
Ton thiidng cdban cua benh la tinh trang thoai hoa sun khop va dia dem (cf cot song c6), phdi hdp vcfi nhiJng thay ddi cf phan xiidng du6i sun va mang hoat dich. Dau cd gay la tinh trang dau cap hoac man tinh tai cot song c6 thiicfngxuat hi^n sau mot ddng tdc dot ngpt, sai tif thg cua cot sdng co, lam viec cang thing keo dai, khi thay ddi thcfi tift hoac xuat hien kin dao. Dau thUdng di kem vcfi co ding ccf va han ch^ v ^ ddng. Nguyen nhan dau cd gay cd nhilu nhUng thiicfng gap nhat la do thoai hoa dot song CO. ThUc te, Y hpc hien dai dieu tri dau CO gay do thoai hda dot sdng cd chu yeu la dieu tri trieu chiing va phuc hdi chiJc nang, ket hc^ dieu tri noi khoa va vat ly tri Heu bang cac nhdm thuoc giam dau chdng viem khdng steroid, gian ccf, thudc dieu tri trieu chiing tac dung cham ket hcfp chieu den hdng ngoai, song sieu am, dien xung, keo gian cpt sdng c6 [9]. Iheo Y hpc cd truyen, benh ly thoai hda ddt song cd thudc pham vi cac chiing 'Ty chiing" Benh phat sinh do chinh khi hU tdn, ngoai ta thifa ccf xam nh^p lam cho kinh lac hi tac, huyet li gay dau, trong do, khi hif Iam ban, huyet ii lam tieu. Vi vay, phap dieu tri khu phong tan han tni thlp thdng kinh boat lac, bd can thin. Dieu tri kdt hcfp cac phUdng phap khong diing thudc nhii dien cham, tap dudng sinh, xoa bdp bam huyet va dung thudc y hgc cd truyen [7], [14]. Tren thiic hanh lam sang, viec sii dung phtidng phap dien cham ket hcfp tap van ddng theo y hoc cd truyen mang lai hieu qua kha quan trong dieu trj dau cd gay do thoai hoa ddt song c6. De cd cd sd khoa hpc danh
gia hieu qua cua dien cham k^t hgp vdi phUcfng phap khdng diing thuoc, khdng xam lan cua y hpc hiln dai vk y hpc cd truyen, chiing tdi tidn hanh di tai nghien ciiu nay vdi mijc tieu:
"Ddnh g^d tdc dung gidm dau cua phUdng phdp di^n chdm kit hdp tdp dUdngsinh trin b^nh nhdn dau cogdy do thodi hoa dotsdng c6"
DO! TUDNG VA PHUONG PHAP NGHIEN CUU
Ddi tifcfng nghien cufu
do benh nhan du!cfc chan doan dau c6 gay do thoai hda ddt song co theo chuSn Iiia cbgn b^nh nhan diicfc dieu tri tai Benh viln Cham ciiu Trung Udng. ThcA gian tif thang 05/2018 din thing 11/2018
Phifdng phap nghien cufu Cd mdu nghiin cvlu
La cd mau tdi thi^u, gdm 60 benh nhan tham gia nghien ciiu chia thanh hai nhdm:
Nhom nghian cufu: Gom 30 benh nhan diicfc dilu tri theo phifdng phap diln cham kit hcfp tap diidng sinh: Dien cham cac buyet: Cham ta: Phong tri, Dde du. Kiln tinh, Kien ngung, Kien trung du, Thien tong, Khiic tri, A thi huyet. Cham bo can du, t h ^ du, tam am giao. [3 ]. Bai tap difSng sinh bang phiidng phap diidng sinh cua bac si NguySn Vsa Hiicfng[5].
Nhom chiing: Gom 30 benh nhan, diidc dieu tri ddn thuan bang dien cham theo phae dd nhii nhdm nghien ciiu
Thietki nghiin cHu
Thiet ke nghien ciiu dpc ket hcfp vdi thii nghiera lam sang ngau nhien co ddi chiing so sanh tnidc - sau dilu tn va so sanh vcfi nhom chiing.
48 I TAP CH[Y DUOC C 6 T R U Y I N VIET NAM ^ 3
^
PhUdngtifn nghiin ctiu Dungcu
Kim cham ciiu vd khuan dai ti( 5 - 8 cm, dung rieng cho tiing ngifcfi, may dien cham hai tin sd bd ta, bong vd khuan, cdn y td 70 dd, Pince vo khuan, khay diing dung cu, thifdc do tim van dpng TVD CSC, thiidc do dp dau VAS, bp cau hdi Northwich Pack Neck pain Questionaire.
Bdi tgp dudng sinh
Theo phUdng phap difdng sinh cua bac si Nguyen X ^ Hifdng. Phae dd cac dgng tac tJip [4], [5], [6] Ngay tap 1 lan, mdi lln 30 phiit: Thu gian 5 - 1 0 phiit; thd 4 thi cd kl mdng va gid chan; iJdn CO 3 - 4 lan; Bac cau 3 - 4 lan; Vgn cdt sdng va cd ngu!(?c chieu 2 - 3 lln; Xem xa xem gan 3 - 4 lan;
Tay CO lai nit ra phia sau 2 - 3 Ian; Bat eheo hai tay sau lifng 2 - 3 lln; Thif gian 5 - 1 0 phiit.
Ngay tip 1 lln, mdi lln 30 phiit.
Phtidngphdp tiin hdnh
Benh nbin difdc lifa chpn vio cac nhdm nghien ciiu se difdc dieu tri theo lieu trinh: Nhom nghiin ciiu: Dieu tri bang dien cham 30 phut/Ian x 1 Ian/
ngay x 30 ngay ket hop tap difdng sinh vdi hlu trinh 30 phiit/lln X 1 lln/ngay x 30 ngay. Nhom chiing:
Dilu tri bang diln chim ddn thuln vdi lieu trinh:
30phut/llnx 1 lan/ngayx30 ngay
*Quy trinh tien hdnh trong mdi budi dii'u tri:
Budc 1: Tnidc khi dieu tri, benh nhin ducfc nghi ngdi 5-10 phiit, do mach nhiet do huyet ap, chuan bi tif the tnfdc khi lam thu thuat.
Budc 2: Quy trinh ky thuat dien cham [3]
- NgUdi benh: Difdc kham va lam ho sd benh an theo quy dinh. Benh nhan d tif the thoai mai, de chiu nhat.
- Ngifdi thiic hien: Bac si, y sy, lifdng y dUdc dao tao ve chuyen nganh y hgc cd truyen difdc d p chuiig chi hanh nghe theo quy dinh ciia phap luat ve kham chiia binh
- Phifdng tien: Kim cham ciiu vd khuan dai S-lO cm dimg rieng cho tiing ngifdi, may diln cham hai tan sd bo ta, Khay men, bdng, con 70°.
- Tien hanh dien cham: Benh nhan ngdi d tif the thoai mai nhat. Xac dinh chinh xac huyet can cham theo phae do [3]
Thii thuat cham: [3]
+ Xac dinh va sat trung da vung huylt + Cham kim vao huyet theo eac thi sau:
Thi 1: Tay trai dung ngdn tay cai va tro an, eang da vung huyet, tay phai cham kim nhanh qua da vung huyet.
Thi 2: Day kim tif tif tdi huyet, kich thich kim cho den khi dat "Dac khi' (benh nhan cd cam gilc cang, tiic, nang vifa phai, khdng dau cf vung huyet viia cham kim, thay thudc cam giae kim miit ehlt tai vi tri huyet).
+ Kich thieh huylt bang may dien cham.: Ndi cap day aia may dien cham vcfi kim da chim vao buyet theo tin sd cua may dien cham. Tan sd (D|t tan sd cd dinh) Tan sd ta tif 5- lOHz, Tan sd bd tif 1 - 3Hz. Cifdng do nang dan cifdng do tii 0 den 100 microAmpe tiiy theo miic chiu difng cua ngu'di benh. Thdi gian 30 phiit cho mdt lln dien cham.
+ Riit kim, sat khuan vimg huyet vifa chim.
Budc 3: Quy trinh tap dUcfng sinh [S]: Tap 30 phiit/lan x 1 lan/ngay x 30 ngay:
+ Thifgian5-10phut.
+ Thd 4 thi cd ke mong vl gid ehan.
+ U'dncd3-41liL + Baecau3-4lln.
+ Van cot sdng va cd ngifdc chieu 2 - 3 lan.
+ Xem xa xem gan 3 - 4 lan + Tay CO lai nit ra phia sau 2 - 3 lan.
+ Bat eheo tay sau lUng 2 - 3 lan.
+ Thif gian 5 - 1 0 phiit.
Chi tiiu nghiin cvlu vd cdch xdc dinh cdc chi tieu nghien cHu
TAPCHIYDUOC CO TRUYEN VIET NAM M
BAI NGHIEN COU
Chi tiiu dgc diim chung
Tien hanh danh gia trifdc dieu tri ve: Phan bd theo nhom tudi, phan bd theo gidi tinh, nghe nghiep
Chi tiiu ldm sdng
Difdc tiln hanh danh gia tai thcfi diem tnfdc ngben ciiu , sau ngbien ciiu 15 ngay sau nghiin ciiu 30 ngay gdm: Danh gia miie dp cai thien dau theo thang diem V\S.
Theo dot vd ddnh gid kit qud diiu trt Danh gia va so sanh eac chi tieu nghiin ciiu tnfdc va sau dieu tri cua doi tifdng nghien ciiu nhu sau: DQ (Thdi diem danh gia tnfcfc khi dilu tq), Bdng 1. Phdn bd binh nhdn theo tuoi d 2 nhdm nghiin
D,5 (Thdi dilm danh gia sau 15 ngay dilu tn), Dj^
(Thdi dilm danh gia sau 30 ngay dieu tri). Cac chi tieu danh gia tgi thdi diem DQ, DJ;, D30 gdm: Miic dp dau theo thang diem VA.S.
Xuflysdlieu
Cac sd lieu diidc xif ly theo tnfdng trinh SPSS 20.0. Cae test thdng ke difdc dirng: X^ - test: So sanh sU khac nhau giiia hai ty 11 %. t - student test:
So sanh si;f khac nhau giiia 2 gia tri trung binh, si;(
khac bilt cd y ngbia tbdng ke vcfi p < 0,05.
KET QUA NGHIEN CUU
Dac diem chung cua doi tifdng nghien ciiu
ctiu
^~^---..^ Nhom
Tuoi frung binh ^~"-.-^^^
18-38 3 9 - 5 9
>60
Tu6i trung binh (nam) X ± SD
NNC(n=30)(a) n 9 14 7
%
30.0 4«.7 23.3 48,87±12.75
NC (o.30)(b) n 9 15 6
%
30.0 50.0 20.0 49.97±I0.08
Tong (n=60) n 18 29 13
%
30,0 48.3 21.7 48,42±1281
P.-b
>0,05
Nhdn xit: O ca hai nhdm nghiin ciiu, do tudi tif 39 den 59 chiem ty le cao nhat. Ty 11 nay d nhdm nghien ciiu (NNC) la 4d,7%, d nhdm chiing (NC) la 50,0%. sif khae bilt khdng cdy nghia thdngke vdi p>0,05 d ca hai nhdm nghien eiiu. Khdng co sif khac biet cd y nghia thdng ke tif dp tudi 18 den 38 va tren 60 tuoi d ca hai nhdm nghien ciiu. Tudi trung binh cua NNC la 48.87± 12.75 cdn NC la 49.97± 10.08.
Bdng2. Phdn bdddi tUdngnghiin cHu theo gidi tinh
Gi^i
Nhom
Nam Na
NNC(n.30)(a) n 14 16
%
4 6 7 534
NC(n=30)(b)
"
13 17
%
43 3 567
Tong (n=60) n 27 33
%
45%
55%
P.-b
>0,05
Nhgn xit: Bang 2 cho thay d NNC ty ll nfl nhieu hcfn nam (nii 53,4%, nam 46,7%), d NC ty le nay la na 46,75, nam 53,3% . Khdng cd sii khlc bilt vl gidi tinh giiia hai nhom vdi p>0,05.
50 I TAP CHI Y DUOC C 6 TRUYeN VIET NAM M
A
Bdng 3. Phdn bo benh nhdn theo nghe nghiep
~~ - - - - _ . ^ ^ ^ N h o m B N Ngh^ nghiep ^---....^^^
Lao dong tri 6c Lao dgng chan tay
NNC (n=30)(a) n 17 13
Tyte(%) 567 43,3
N C (n=30)(b) n 16 14
Tyle {%) 53,3 467
P.,b
>0,0S
Nhdn xet: O hai nhdm nghien ciiu, ty le lao dgng tri dc cbi^m ty le cao hdn lao ddng chin tay trong dd cd 56.7% d NNC, cdn d NC la 53.3%. Sif khac bilt ve nghe nghiip giiia bai nhdm khong cd y nghia tiidng ke vdi p>0,05.
Si^ tJiay ddi vi miic dd dau theo thang di^m vas sau 15 ngiy di€u tri d nhom nghien cufu Bieu do l.Tyle% miic do dau cua hai nhdm nghiin cHu qua cdc thdi diim
140 •
100 -
60 - 40 -
0 -
•
D3Q- -
40
0 , 0 . P I ,
D30
D15 53)3
40 . ^ H
:ll
D l S
60
^M D30 DO
76,7
1
i ^ ^ i U 1 U 1 1 Khong dau Bau it Dau vifa Rat dau
Bang 4. Stf thay ddi mUc do dau theo thang diim VAS d NNC trUdc dieu tri vd sau 15 ngdy dieu tri
Miscdjodau
Thdidi^m
Khongdau Dau it Dau viia Rit dau
D , (n n 0 0 8 22
=30) Tyl^(%)
0 0 267 73 3
"„(•' n 0 12 18 0
=30) Tyle(%)
0 40,0 60,0 0
PDO/DIS
<0,05
Mian xet: Tif bieu dd 1 va bang 4 cho thay sau IS ngay dieu tri, eo 60% benh nhan d miic dp dau vifa va 40,0% benh nhan d miic do dau it, khdng ed benh nhan nao d miic dp rat dau hay khdng dau. Stf khac bilt d NNC tai hai thdi diem trifdc dieu tri va sau IS ngay dieu tri co y nghia thong kl vdi p<0,05.
TAP CHI Y DUOC CO TRUYEN VI^T NAM 1383^03
BAI NGHIEN c t r u .
Bang 5. Suthay d6i mUc dd dau theo thang dUm VAS d nhdm NNC sau 15 ngdy dHu tri vd sau 30 ngdy diiu tii
Mile do dau ——-...^^
Khong dau Dau it Dau viia Rltdau
D „ ( n = 3 0 ) n 0 12 18 0
Tyle(%) 0 40,0 60.0 0.0
D3.(n=30) n 12 16 2 0
Tyl?(%) 40.0 53.3 6.7 0.0
PBIS;DJD
< 0 , 0 5
Nftfln «et: Tif bieu do 1 va bang 5 cho thay sau 30 ngay dieu tri d NNC sd benh rihin d miic dd dau it chiem 53,3% so vdi thdi diem sau 15 ngay dilu tri la 40%; binh nhin khdng dau chiem 40% so vdi thdi diem sau 15 ngay dilu tri la 0%; benh nhan dau vifa dii cdn chiem 6,7% so vdi thdi diem sau 15 ngay dilu tii la 60,0%. SiS khae biet d NNC tai hai thdi diem sau 15 ngay dieu tn va 30 ngay dilu tri cd y nghia thdng ke vdi p<0,05.
Bdng 6. Sii thay ddi mUc dd dau theo thang diim VAS dNNC tnidc diiu tri vd sau 30 ngdy diiu tri
-—...^^^ Th6j di^m
MiJicdodau ,—...^^
Khong dau Dau it Dau viia Rat dau
D,(n=30) n 0 0 8 22
Tyle(%) 0.0 0.0 267 733
D,.(n=30) n 12 16 2 0
Tyle (94) 400 533 67 0.0
Pl»,l)»
<0,0S
Nhgn xit: Tif bieu dd 1 va bang 6 cho thiy sau 30 ngay dilu tri d NNC cd 0,0% benh nhan cf miic dd rit dau, 6,7% benh nhan d miic dp dau vifa, 53,3% benh nhan d miie dg dau it va 40,0% benh nhan khdng dau. So vdi NNC tnfdc khi dieu tri cd benh nhan d miic rit dau chilm 73,3% va dau vifa chilm 26,7%. Sif khac biet ve miic do dau theo thang dilm VAS ciia NNC & hai thdi diem tnfdc dieu tri va sau 30 ngay dieu tri cd y ngbia thdngke vdip<0,05.
Bdng 7. Su thay doi diim VAS trung binh cua hai nhom nghiin cHu tgi 3 thdi dUm trUdc diiu tn, sau 15 ngdy dieu tri vd sau 30 ngdy dtiu tri
^~~'~~—-..._^^ Nhom Thdi diem ~~~~-^^^^
D,(n=30) D„(n=30) D,.(n=30)
P
NNC (X±SD) 6,47 ±1,45
3,13±1,5 U 7 ± l , 0 2 P.(D„D,a<0,05, Pb(i)iiB»)<0,05, P,(I»DW<0,01.
NC ( X + S D ) 6,4+1,54 3,57+1,41 1,83 ±0,98 P,(DHO.S)<0.0S, P«D«D3«<0,05, Ph(DaD30)-=0,05.
p
> 0 , 0 5
> 0 , 0 5
< 0 , 0 5
52 I TAP CHI Y DUOC CO TRUYiN VIET NAM MtliMJillitiUllll
^
Nhgn xit: Sau dieu tri 15 ngay va 30 ngiy, miic dp dau tiieo thang diem VAS thay doi co y ngbia thdng ke so vdi tnfdc dilu tn vcft p<0,05. & thdi diem sau 15 ngay NNC cd cai thien dau tdt hdn NC nhifng sif khac biet giiia hai nhom khong cd y nghia thdng ke vdi p>0,05. Sau 30 ngay cai thien miic dg dau theo thang diem VAS cua NNC tdt hdn NC va sif khac biet cd y ngbia thdng kl vdi p<0,05.
BAN LUAN
Dac diem chung cua doi tiidng nghien cufu Dgc dii'm vitu6i cua hinh nhdn
O cahai nhdmbenh nhan, nhdm co do tudi tren 39-59 chiem ty ll cao nhat (chilm 46,7% d NNC va 50,0% d NC), tiep den la nhom >60 (chiem 23,3% d NNC va 20,0% d NC), cdn Iai la nhdm 18-38 tuoi (chiem 30% d NNC va 30% d NC)).
Tinh theo tifng nhdm tudi cua hai nhdm nghien ciiu tbi sif khac bilt khdng cd y ngbia thdng ke (p>0,05).
Ket qua nay phii hdp vdi ket qua aia Phan Kim Toan va Ha Hoang Kilm la 30-50 tudi (70%) [ll]... Theo Ll Tu benh nhan do tuoi SO tudi trd len chiem ty le cao nhat (67,2%), tiep den la nhdm tif 40-49 tuoi (21,4%) vl thap nhat la nhdm tif 30- 39 tudi (11,4%), tudi trung binh cua doi tUdng la 53,8±11,4 tudi [12]. Dp tudi cua benh nhan trong nghiin cilu nay tifdng ddng vdi cac nghiin ciiu khac va cimg phii hdp vdi sinh Iy hpc, binh hpc ve thoai hda ddt sdng cd thifdng gap d ngifdi cd qua trinh lao hda tif nhien ciia cd xiidng khdp.
Dgc diim vegidt tinh
Trong nghien ciiu nay cd benh nhan nii nhieu hdn nam. Ty le benh nhan mi/nam la 55%/45%.
Tuy nhien ket qua phln tich cQng eho thay sU khac biet khdng cd y nghia thdng kl ve gidi tinh giiia hai nhdm nghien ciiu vdi p>0,05. Mdt sd nghiin ciiu ve thoai hoa ddt sdng cd cung ghi nhan ty
ll nii nhieu hdn nam: Nghiin ciiu ciia tac gia Nguyin Thi Thamnii69%, nam 31% [13]. Theo Minanta Sharmin (2012), na chilm 49% nam chiem 51% [15].
Sii khac biet nay do die dilm chpn benh nhan cua tifng dia diem nghiin ciiu, moi nghiin ciiu chi cd cd mau nhd, Ichdng mang tinh dai diln cho ca quan the nen chUa phan anh khach quan ty ll nam/
nii cua ca quin the. Ty II nii nhilu hdn nam phan nhieu do nii hin quan den dg tudi sinh de, man kinh din den ty le thoai hda sdm va nhieu hdn nam gidi. Ddng thdi nfl gidi ludn quan tam den siic khde hdn nam gidi nen hp thifdng di kham va dieu tri sdm khi ed diu hieu cua benh
Dgc diim vinghinghiip
Ket qua bang 3 cho thay lao ddng tri dc cao hdn lao ddng chan tay. Cii the la la lao dgng tri dc ehiem 56,75% d NNC va 53,5% d NC, lao dgng chan tay chiem 43,3% d NNC va 46,75 d NC. Sii khac bilt giiia hai nhdm khong cd y nghia thdng ke vdi p>0,05. Kit qua nay pbii hcfp vdi ket qua ciia Ho Dang Khoa benh nhan thudc lao ddng tri dc chilm 55% [8]. Nhdm hoait dpng tri dc nhif hanh chinh van phdng thudng lim vile ban gily, tif the cd dinh, gd bd keo dai, trong do dau va cd thifdng xuyin d tif thi cd dinh la ciii, day ta yeu td thuln Ipi din den dau va co ciing cac cd, xuit hiln THDSC sdm.
StJl cdi thiin vimvCc do dau theo thang diim VAS Kit qua phln tich cho thiy neu xet theo miic dp dau theo thang diem VAS sau 30 ngay dieu tri, phifdng phap diln cham ket hdp tap difdng sinh cd tac dung hit hoan toln ty le benh nhin d NNC rat dau (tif 73,3% xudng cdn 0,0%) ddng thdi lam gia tang benh nhan d miic dp dau it tif 3,3% len 53,5%. Die bilt 40% benh nhan d NNC cho bilt ban thin khong eon cam giae dau trong khi NC chi c6 10%... Trong nghiin eiiu nay d thdi dil'm sau
TAP CHI Y DUOC CO TRUYiN VIET NAM UtltUJiliz^Alill] 53
BAI NGHIEN CLTU •
30 ngay cho thiy sif khac biet giiia hai nhdm cd ^ Sau 30 ngay dieu tri d NNC miic dp dau theo nghia thdngke vdi p<0,05. thang diem VAS la 1,17±1,02 dilm, tnfdc dilu tn la 6,47±1,45 diem. C NC miic dp dau theo thang KET LUAN dilm VAS la 1,83±0,98 diem, tnfdc dilu tri la Phifdng phap dien chim kethdp tap dtidng sinh 6,4±1,54 diem. Sd khac biet giiia hai nhdm cd -^
CO tac dung giam dau t6t hdn so vdi diln cham nghia thdng kl vdi p<0,05.
ddnthu^.
TAI LIEU THAM KHAO
1. Le Tuan Anh (201S). "Ddnhgid hiiu qud diiu trt dau vai gdy do thodi hoa cdt song co bdng phiidng phdp diin chdm, xoa bdp bdm huyet kit hdp diin xung", Tnfdng Dai hpc Y Ha Ndi,
2. Trin Ngpc An, NguySn Ngoc Lan (2013). "Phdc dd chdn dodn vd diiu trt cdc binh cdxUdng khdp thudng gap", Nha xuat ban Gilo due Viet Nam, tr.212-2l6.
3.Bo YTS(201S). "Hudngddn quy trinh ky thudt khdm binh, chQa binh chuyin ngdnh chdm ctiu", NXB YHgc,tr.750-7S2.
4. Pham Thiic Hanh (2001). "Nghtin ciiu biin ddi ldm sdng vd thdng khi phdi d binh nhdn bui phdi silic sau tgp khi cdng dUdng smh vd diing bdi thuoc c6 truyin", Lu|n van thac si Tnfdng D ^ hpc Y Ha Ngi, 5. Pham Thiic Hanh (2010). "Giflotrin/ifc/ii'cofigtiu'ohgsiM/i", Hpe viln YDdd'c hpc c6 truyen Viet Nam, tr.264-265.
6. Nguyin Van Hiiofng (1984). "P/iifCngp/]flpdif?fJg5in/i", Sd Van hda va Thdng tin Long An tr.103-148.
7. Nguyen Nhifdc Kim (2015). "Vai trd cua Y hgc c6 truyen vd kit hdp y hoc hiin dgi trong diiu tri mdt so binh mgn tinh", NXB Y Hpc, tr.9 - 20 80 - 86.
8. Ho Sang Khoa (2011). "Bdnh gid tdc dung dieu tri dau vai gdy do thodi hda cdt song c6 bdng phUdng phdp xoa bdp bdm huyet kit hdp tap van dgng theo y hgc co truyen", Hoc vien Y difdc hpc c6 truyin Viet Nam, 9. Nguyin Ngoc Lan (2011). "Binh hgc cd xUdng khdp ndi khoa", Nha xuat ban Giao due Viet Nam, tr.140-153.
10. Hd Hfiu Lifdng (2018). "Thodi hda cot sdng cd vd thodt vi dia dim", NXB Y Hpc, tr.79.
11. Phan Kim Toan, HI Hoang Kiem (2003). "Nghiin ciiu trieu chiing ldm sdng, hinh dnh X - Quang vd kit qud diiu tri thodi hda cdt sd'ng cd hangphUdngphdp keo ddn". Tap chi Y hgc quan sif sd 6
12.LeTii(201S)."DdnhgidtdcdungcuaxoabdpbdmhuyitkithdpbdibodUdnghodnngiithangtrongdiiu tri dau vai gdy do thodt hda cot sdng cd", Lu|n van thac si Y hoc,
13. Nguyin Thi Tham (2008). "Ddnh gtd hiiu qud dieu tri dau cd vai gdy trong thodi hda cot song c6 bang mgt sophudngphdp vdt ly tri lieu kit hdp vdn dgng tri lieu", Luan vln thac si y hoc dai hgc Y ha Ngi, 14. Triidng Dai hpcYHaNoi-Khoa Yhpc CO trayen (2005). T%e«(?g"npifc;iofl7/ipc CO tra^/^'n'^NX^
Yhge,tr.514-517.
15. Minanta Sharmin (2012). "Characteristics of neck pain among cervical spondylosis patients attended at CRP", Bangladesh Health professions Institute, Bangladesh.
54 I TAP CHI Y DUOC C 6 TRUYCN V|£T NAM L4.l»M«l:li:kAltlL-l