BAI BAD KHOA HOC
UllVG DUNG LIEU
P H A PflIEU TRj BANG TAY DIEU TRj HOI CHVlNG THOAI HOA DOT SONG CO CUA CAN RU VAN PHilNG TAI TRlTifNG DAI HOC THE DUC THE THAO RAC NINH
Tru'o'ng DLPC Thang*
Cfng dyng lieu ph^p dieu tri bang tay vdi cac thO phap xoa bdp, bam huySt vd tdc d^ng c O t s l H de tdi da dilu trj thoai hda dot song c6 cho can bp van phdng tai Tru'd'ng Dai hpc TDTT Bdc Ninh.
TCr khoa: Dieu tn bang tay, xoa bdp, bdm huypt, tac dpng cot s6ng, thodi hda d6t s6ng c6.
Application of manual therapy for treatment of degenerative spine syndrome of office staffs at Bac Ninh Sport University
Summary:
Applying manual therapy with massage techniques, acupressure and spinal actions have treated degenerative spine for office staffs at Bac Ninh Sport University
Keywords: Manual treatment, massage, acupressure, spinal actions, degenerative spine. J UAT VAN BE hpc thdng ke. Chin doan va danh gia hieu qua Thoai hda cot sdng cd la mdt trong nhirng can ^^% dung dugc dua tren 2 tieu chi: Cam giac dau benh phd bien cua nhiing ngudi lam cdng tac van
phdng. Thoai hda ddt sdng cd va lung khdng chi d nhiing ngudi gia ma cdn d ca nhirng ngudi tre thudng lam viec trong van phdng, it van ddng hoac phai ciii nhieu, phai sir dung nhiiu dpng tac anh hudng den vimg dau cd. Cac diu hieu diin hmh cua benh cd the de nhan thSy 1^ cd ciing, khd xoay chuyen kem vdi dau hieu dau, vimg cd sau dd lan xudng vai, gay dau cac khdp cd va vai, ngoai ra cdn bieu hien dau dau khdng ro nguyen nhan.. .Thoai hda dot sdng cd gay ra nhieu khd khan trong smh hoat va lao dpng cho ngudi benh.
va han che tam van ddng theo 4 miic do.
K^TquA NGHliN C0UVA BAN LUAN 1. ThLFC trang ve cac bieu hi$n thoai hda dot song c6 cua can bo van phong Tru'd'ng Dai hoc TDTT Bac Ninh
Thdng qua phdng vin 120 can bd van phdng tai Trudng Dai hpc TDTT Bic Ninh, ehung tdi da xac dinh dupe th\rc trang thai hda ddt song cd chii yeu xuat hipn d dp tudi trung va cao tuoi, eu thi: Dp tudi tren 55-62 vdi nam 71.4%, ddi vdi nu la 100%; dac biet, cac trieu chiing da xuit hien vd'i dp tudi tre, liia tudi 35-44 nam Ty le mac benh gap ca hai gidi nam va nu gin chiem 62.5%, nii la 57.9%
nhu ngang nhau.
PHI/dNG PHAP NGHIEN C((U
Qua trinh nghien cmi sir dung cac phuang phap sau: Phuong phap t6ng hap va phan tich tai lieu; phuang phap phong vin, toa dam;
phuang phap kiSm tra y hoc; Xoa bop - bSm huyet - tac dong cot s6ng va phuang phap toan
2. Lu>a chon bien phap dieu trj thodi hda dot sSng co bang tay cho can bo van phong tai Tru'dng Dai hpc TDTT Bac Ninh
Thong qua phuang phap dpc va phan tich tai lieu, k^t qua phong van ehung toi da lua chpn duae lieu phap diSu tri bJng tay, cac thu phap xoa bop, b4m huyet va tac dpng cot song, bao gom:
Xoa bop; Gom 3 ky thuat, Xoa vu6t; Xoa
*ThS, Truong Bai hpc TDTT Bac Ninh; Email: [email protected]
miet; Ky thuat nhao co.
Bam huyet: Phong tri, Kien tmh, Kien ngung, Dai trii, D^i chuy. Hop cdc, Giap tich.
Ky thuat tac ddng cot sdng: Giai toa trpng diem viing cd tren tii Cl den C3, giai tda frpng di§m vung cd duai tu C4 ddn C7, giai tda tt"png diem viing cd dudi tir Dl den D3.
3. Quy trinh dieu trj bang xoa bop, bam huyet va tac dpng cot song
Tren co sd ly luan va thuc tiln de tai tien hanh xay dung quy trinh thuc hien cac ky thuat xoa bop, bam huyet va tac ddng cdt sdng nhu sau:
3.1. Ky thudt xoa bdp:
Tien hanh xoa lam ndng cac nhdm ca d cd, cac CO viing dai vai, co thang. Ngudi dupe xoa bdp d tu the ngdi, nguoi xoa bdp diing ddi dien, mdt tay do cam sao cho trpng tam cua dau roi vao cam (de co cd hoan toan tha Idng). Ky thuat vien xoa bdp se tu thuc hien ddng t^c sau:
Xoa vuot.
Xoa vudt bing hai ban tay thi xoa bdp vien dung song song vdi bp phan dupe xoa bdp, cdn neu thuc hien xoa vudt lien hoan theo dudng thang thi dung vudng gde .
Xoa miit.
Midt bang mdt tay hoac cd sir trp giiip ciia tay kia. Xoa bdp vien diing vudng gdc vdi bp phiin dupe xoa bdp va xoa miet bang gd ngdn tay cai hoac ngdn tay lit cua mpt tay.
Xoa xdt.
Thuc hien tir chSn tdc phia sau gay xuong dudi ddn lung bing 4 ngdn tay ciia mdt hoac hai tay, luan phien vdi xoa xat theo dudng thang va duong xoin dc bing ngdn tay cai va xoa xat
theo dudng trdn bang cac khdp ngdn tay (nam dam). Sau khi thuc hien xong tien hanh xoa bdp d phan cd ddi dien va ket thiic bang ddng tac xoa vudt d tu the diing song song.
Nhao ca.
Gdm nhao co bang mpt tay, hai tay va nhao CO bang cac dau ngdn tay, nhao co bang phan mem ngdn cai.
Thdi gian cho mdi lan dieu tri: 30 phiit/lan/ngay
- Lieu trinh: 30 ngay, ngay 1 lan 3.2. Ky thudt bdm huyet:
Chpn huyet A thi (thien ling huyet, thdng diem) la diem dau do ngudi benh ehi ra hoac do bac sT kham thay cd tac dung chdng dau tai ehd nhu dau co, dau xuong khdp, dau than kinh.
Lan can thu huyet la chpn cac huyet theo vung dk didu tri trong nghien ciiu la: Phong tri, Kien tinh, Kien ngung, Dai chir, Dai chiiy.
• Huyet Phong tri thudc kinh Tiic thieu duong ddm vi tri tir giiia xuong cham (Cl) do ngang ra 2 thdn, huyet d ehd triing phia ngoai CO thang, phia trong co tic ddn chum. Huyet cd tac dung trir phong, chiia dau dau, hoa mat chdng mat, dau vai gay deu la cac trieu chiing thucmg gap trong THCSC.
• Huyet Kien tinh thupc kinh Tiic thieu duong ddm vi tri d tren vai nam giua dudng ndi tu Dai chuy den dinh vai. Huyet cd tac dung dieu tri dau vai gay, te tay.
" Huyet Kien ngung thudc kinh Thii duong minh dai tnrdng nam d giira mom cung vai va mau chuyen Idn xuong canh tay, chinh giiia phan tren co delta. Khi lay huyet bao benh nhan
BAI BAO KHOA HOC
MOW • • " " •
HuyH CHOUONQ
M6m c&ng vat (HitPltolKHU
(TnnoiU
OliPTlWHWDA
gia ngang tay xuat hien cho 16m d me dudi bd truac mom cung vai, huyet d chinh giira cho 16m dd. Huyet ed tac dung dieu tri dau vai, te dai ngdn tay hoac khd cu dpng.
• Huyet Dai trii: Vi tri tir khe giua D1-D2 do ngang ra 1,2 thdn thupc kinh Tiic thai duong bang, huyet hpi cua ve cdt chii xuong, la nai giao hdi cua cac Idnh duong. Do vay huyet cd tac dung trir phong khu ta, thu can mach, dieu cot tiet chua dau vai gay, dau dau.
• Huyet Dai chiiy: Nam tren mach Ddc la huyet hpi ciia mach ddc voi 6 kinh duong, lay huyet d ehd 16m mdm gai dot sdng cd 7 hay tren ddt sdng Dl. Tac dung dieu tri tai cho: Dau ciing cd gay, dau dau, dau nguc sudn va nang cao siic khde.
Lay huyet theo nguyen tac vien bd thu huyet cd huyet Hpp cdc. Huyet Hpp cdc la huyet nguyen cua kinh Thu duong minh dai trudng nam d ke xuong ddt ban tay 1 va 2 tren co lien ddt mu tay 1, phia duai trong xuong ddt ban tay 2 cd tac dung dieu tri dau viing diu mat, dau vai gay, hoa mat chdng mat, u tai, dau diu.
Hoa da giap tich d hai ben cdt sdng, each dudng giiia khoang 0,5 thdn vk phia ngoai tir ddt sdng Dl ddn S4 cd 17 ddi huyet vi. Trong nghien ciiu nay dung huyet Giap tich tii Dl/2 den D5/6 dieu tri benh dau ciing dpc viing vai gay, dau hic nguc.
3.3. Ky thudt tdc dpng cot sdng:
3.3.1. Gidi toa trpng diim viing co tren tie Cl din C. Phuong thicc song, 2 tu the:
Tu thi ngdi co cui gap: Giai tda trpng didm cd hinh thai Ioai Mdm Don va Lien Lech tir Cl ddn C3.
(L.I.-1S)
Xirffngddn
Tu the nam ngiia cd: Giai tda cac hinh thai cua trpng diem loai Don hoac Lien Ldi, Loi Lech, hoac Lech, co ciing xa, khu tni trong viing tirCld6nC3.
3.3.2. Gidi tda trpng diim vung co duoi tir C4 den C7. Phuong thuc Song ung dung 3 tu thi:
Tu the ngdi guc dau: Giai tda trpng didm khu tni ttr C4 den C7, cd hinh thai L6m, Ldm Lech, Teo, Nhupc.
Tu the ngdi ngiia cd: Giai tda trpng diem khu tni d vimg tir C4 dSn C7 cd hmh thai Don ho^ic Lien Ldi, Ldi Lech, co ciing.
Tu the nam sap lip mat: Giai tda trpng diem khu tni tir Cl din C7 cd hinh thai Lorn, Ldm Lech, Teo, Nhupc, Xa.
3.3.3. Gidi toa trpng diim vdng lung trin tu Dl den D3. Phuang thiic Song ung dung 2 tu the:
Tu the ngoi ngay: Giai tda trpng diem khu tru d viing tren lung tren cd hinh thai Ldi hoac Loi lech.
Tu the ngdi ngay guc dau: Giai tda trpng diem khu ttii d phan tren lung tren tir D1 den D3 khu tni trong ldp co sau cd hinh thai Lorn, Ldm Lech Don hoac Lien.
3.4. Ky thudt keo gian:
3.4.1. Keo gian co: Ddt cd hai tay ra sau co (phia truac) nguai duoc xoa bop vd keo vephia hqn, tqo nin mpt luc keo nhe a co. Lap Iqi dpng tdc nay vdi Idn.
Keo gian diu quay nghieng: Dat tay phai phia dudi cam ngudi dupe xoa bdp, cdn tay hai di duai gay ch6 hop so, hai tay tac dung mpt li^c ddu nhau. Nhe nhang va that can than keo deu vd pha sau. Giu tu thi nay trong khoang thcri
gian it nhat la 10 giay. lap lai ddng tac nay vai lan.
3.4.2 Keo gian vai vd cd: Nim chat hai ban Phuong phap 2: Lap lai ddng tac nhu tren tay lai, dat phan mem tren cang tay len mdm vai nhung lan nay hudng dau ngudi dupe xoa bdp cua nguoi dupe xoa bdp, cin than dat cing tay
cdn lai dua vao diu ngudi nay, ngang vdi Id tai.
Nhe nhang an that nhe len diu, cdn vdi vai thi an manh hon mpt chiit. Lap lai dpng tac nay d phia ben kia.
3.4.3. Ndng cdnh mpt bin a tu thi ngoi:
Ngdi quy trong khi dau gdi trai ciia ban nhe nhang gac ngang dui ngudi dupe xoa bdp. Cho long ban tay ciia ngudi dupe xoa bdp tua vao mdt ben dau ngudi ay. Sau dd day khuyu tay trai ra xa de gap cd va than ngudi dupe xoa bdp theo chiiu ngang sang phia ben phai. Giii tu thi dd trong vai giay rdi lap lai ddng tac nay cho phia ben kia.
3.4.4. Keo nan theo tu the cdnh buom:
Phuong phap 1: Ngudi dupe xoa bdp d tu the ngoi, dan hai tay vao nhau, da sau dau, edn ngudi xoa bdp ludn hai ban tay minh dudi bip tay ngudi dupe xoa bdp rdi dan chat ca hai tay chdng len tay ngudi dupe xoa bdp. An xudng di cho ngudi dupe xoa bdp gap ngudi xudng ve phia truac. Giii tu the nay trong vai giay. Sau dd
ve mdt ben dau gdi, rdi sau dd hudng ve phia dau gdi cdn lai van cpt sdng.
4. Hieu qua bien phap dieu trj hoi chii'ng vai gay bang tay cho can bp van phong tai Tru'd'ng Dai hoc TDTT BSc Ninh
4.1. To chue thifc nghiem:
Nghien ciiu dieu tri kiem chiing dupe thuc hien d 30 can bd bi thai hda ddt sdng cd voi cac miic dp khae nhau hi dp 2 trd len, thdi gian bit diu diiu tri tir ngay 1/3/2018 din ngay 30/3/2018.
Tai Phdng xoa bdp b§m huyet cua Bp mdn Y sinh hpc TDTT va Cau lac bd Y hpc TDTT
4.2. Ddnh gid hiiu qud:
De tai da sir dung 02 tieu chi de danh gia:
Thang diem danh gia dau theo cam nhan benh nhan (VAS) va Tam van ddng cac ddt song cd va vai vdi 04 miic dp tang dan. Hieu qua ihig dung lieu phap xoa bdp, bam huyet va tac ddng cdt sdng truoc va sau thuc nghiem dupe trinh bay tai bang 1.
Ket qua bang 1 cho thay ca 2 tieu chi kiim tra danh gia thoai hda dot sdng cd sau thdi gian Bang 1. Ket qua irng dung lieu phap phoi hp'p dieu trj thoai hoa dot song co
bang cac thu phap xoa bop, bam huyet, tac dong cot song va keo gian cho can bp van phong Tru'o'ng Dai hoc TDTT Bac Ninh tru'd'c va sau thu'c nghiem
Mu-c do dan gia
Miic 2
Miic 3
Miic 4
Tieu chi danh gia Thang diem danh gia dau theo cam nhan benh nhan (VAS) Tam van dong cac dot song CO va khap vai
Thang diem danh gia dau theo cam nhan benh nhan (VAS) Test tam van dong cac dot s6ng CO va khap vai Thang diem danh gia dau theo cam nhan benh nhan (VAS) Test tam van dong cac ddt sdng c6 va khop vai
Ket qua so sanh Truoc
TN 18 22 9 7 3 1
SauTN M i i c l
16 19 7 6
%
88.90 86.40 77.80 85.70
Miic 2 2 3 2 1 2
%
11.10 13.60 22.20 14.30 66.70
Miic 3
1 1
%
33.30 100
BAI BAO KHOA HOC
phdi hpp diiu trj deu giam so vdi truoc thuc nghiem d cac miie dp khae nhau, dieu do chiing td lieu phap diiu tri bang tay ap dung tren ddi tupng nghien ciiu da phat huy hieu qua. Ket qua dat dupe cu the d timg tieu chi nhu sau:
Ve cam gidc dau:
Miic dp 4: Trude thuc nghiem la 3 ngudi, sau thuc nghiem 01 ngudi da chuyen ve miic 3 (33.3%) va 02 ngudi da chuyen ve miic 2 (66.7%).
Miic dp 3: Tnrdc thuc nghiem cd 9 ngudi, sau thirc nghiem 02 ngudi da chuyen ve miic 2 (14.3%) va 07 ngudi da chuyen ve miic 1 (75.7%).
Miic dp 2: Tnrdc thuc nghiem cd 18 ngudi, sau thuc nghiem chi cdn 2 ngudi (13.6%), 16 ngudi da chuyen vk miic 1 (86.4%).
Ve hqn chi tdm van dpng:
Miic dp 4: Truoc thuc nghiem cd 1 ngudi, sau thuc nghiem da chuyin vi miic 3 (100%).
Miic dp 3: Tnrdc thuc nghiem cd 7 ngudi, sau thuc nghiem 01 ngudi da chuyin vi miic 2 (11%) va 06 ngudi da chuyin vi miic 1 (89%).
Miic dp 2: Tnrdc thyc nghiem cd 22 ngudi, sau thuc nghiem ehi cdn 3 ngudi (20%); 19 ngudi da chuyen vi miic 1(80%).
KETLUAN
Tir ket qua nghien ciiu cua di tai cho phep nit ra mdt sd ket luan sau:
1. Ket qua nghien cim da eho thiy thyc trang thoai hda ddt sdng co ciia can bd van phdng
"4 Thoai hoa dot s6ng c6 voi cac bieu hien cOng ca, moi vung ca vai gdy, dau vLing CO gay... la "benh nghe nghiep" cua can b$
van phong, nhirng ngiFd^i phai ngoi lam vi^c vd'i mdy tinh nhieu gid> moi ng§iy Trudng Dai hpc TDTT B i c Ninh cu t h i cd 30 can bp bi thodi hda ddt sdng cd bieu hidn d cac trieu chiing nhu: Dau vimg cd gay, han chi v§n ddng ddt sdng cd, ciing ca, mdi co vung vai gay khi ngdi lam vide...
2. Kit qua da lua chpn duoc lieu phap dieu tri bing tay kit hpp 3 thu phap (xoa bdp, bam huyet va tac dpng cdt sdng) de dieu tri benh thai hda dot sdng cd cho can bd van phong Truong Dai hpc TDTT Bac Ninh. Kit qud kiem tra sau thyc nghiem da cho thay cd su thuyen giam dang ke ve sd lupng cung nhu miic do so vdi truoc thuc nghiem.
lAillEO THAM KHAO
1. Ducmg Xuan Dam (1987), The due phuc hoi chtie ndng, Nxb TDTT, Ha Noi
2. Luu Quang Hiep, Pham Thi Uyen (2003), SmA/y Ape TBTT, Nxb TDTT, Ha Noi.
3. Le Hmi Hung (2013), Kiim tra y hgc thi due thi thao, Nxb TDTT, H4 Npi
4. Le Huru Hung, Vu Chung Thuy, Nguyin Thanh Nhan (2010), Hoi Ph^c chue ndng vd Vdi ly tri lieu, Nxb TDTT, Ha N6i.
(Bai n6p ngay 26/10/2018, Phan bien ngly 5/11/2018, duySt in ngay 28/11/2018)
