VIETNAM MEDICAL JOURNAL N"1 - U U I U b t K - z m / TAI UEU THAIVI KHAO
1. Schieve LA, Peterson HB, Meikle SF, Jeng G, Daiiel I, Burnett NM, et al. Live-birth rates and multiple-birth risk using in vitro fertilization. 1 Am Med Assoc. 1999; 282:1832-8.
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3. Gad, Shayne C. (2002), "Acute Toxicity Testing in Drug Safety Evaluation", Drug Safety Evaluation, Wiley - Interscience a 3ohn Wiley and Sons, InC, Publication, 1, pp. 130-75.
4. Gad, Shayne C. (2002), "Subchnsnic and Chronic Toxicity Studies", Drug Safety Evaluation, V/iley -
Interscience, a John Wiley and Sons, InC^
Publication, 1, pp. 237-57. ' i. Bo Y Te (1996) "Phu luc 3: Hu'dng d|p ve khao s^t
dpc tinh thude cd truyen", Hu'dng dan nghien aiu danh gia bnh an toan va hieu lut thuoc co truyen Viet Nam, tr. 41-6.
>. Do Trung Dam (2006), PhUdng phap nghien c0 tac dung dWdc ly cua thude td' dude thao, NXB' Khoa hoc va Ky thuat Ha Ndi , tr. 335- 42, 347-52 355-368, 377-392 .
', Doan Thj Nhu (2005), "Cham soc, sinh san va quan ly dong vat thi nghiem", Phudng phap nghien cljh tac dung dude ly cua thua: td" dUdc thao, Vien Di/d:
Ueu, NXB Khoa hoc va Ky thuat Ha Noi, tr. 22-7.
DANH GIA KHA NANG PHUC HOI VAN DONG COT SONG THAT LU'NG CUA THUOC "BO THAN T R A N G DU-ffNG H O A N " (y BENH NHAN
MAC CHU'NG DAU THAT LU'NG THE THAN DU'ffNG HU*
Doan Quang Huy*
T6IVI TAT
Nghien cuU dieu tri ciia "Bo than trang dUdng hoan" d 30 benh nhan mac chirng dau that lUng the than ducfng hU ve kha nang phuc hoi van dong cot song that luhg. Ket qua cho thay, nghiem phap Schober, cu' dong gap duoi cot song, dpng tac nghieng cot sdng sang phai, trai va dgng tac xoay cot song sang phai trai cai thien dan sau thdi gian dieu tn, tuy nhieu tang ro sau 30 ngay dieu tri. Ket qua nghiem phap Schober ll-12em giam di (0% so v6i 6.
67%), phan tram ket qua nghiem phap Schober 11- 12em giam 100.0%; ket qua 12-13 cm cung giam (3.33% so vdi 43.33%), phan tram ket qua 12-13em giam 92.3%; ket qua >14em cung giam (60.0% so vdi 0.0%), phan tram ket qua >14cm t§ng 100.0%. Cir dong gap va duoi cot song cai thien (79,29° so vdi 88,53° va 17,29° so vdi 22,79°); dpng tac nghieng cot song sang phai va trai cai thien (23,79° so vdi 30,29°);
ddng tac xoay cot sdng sang phai va trai cai thien (33,59° so vdi 41,07°).
SUMMARY
AN EVALUAHON OF REHABIUTATION OF THE LUMBAR SPINE OF THE REMEDY "BO THAN TRANG DUONG HOAN" ON THE
PATIENTS W I T H LOWER BACK PAIN CAUSED BY KIDNEY M/Vff DEFICIENCY
Research on the treatment of "Bo than trang dUdng hoan" for 30 patients with renal lumbar spine disease for resuscitation of lumbar spine movement
"Hoc vien Y Dddc hgc cd truyen VN Chiu trach nhiem chinh: Ooan Quang Huy Email: [email protected] Ngay nhan bai: 18.6.2017 Ngay phan bien khoa hpc: 30,8.2017 Ngay duyet bai: 6.9.2017
revealed the results of Schober's trial; Straining and stretching of the spine; Movement of the spine to the right, the left and the rotation of the spine to ttie right, the left to improve gradually after the treatment time, but increased significantly after 30 days of treatment, specifically: Schober 11-12 cm test resulfe decreased (0% compared to 6. 67%), percentage trf test results Schober 11-12 cm decreased by 100.0%;
Results of 12-i3cm also decreased (3.33% compared to 43,33%), the percentage of results 12-13 cm decreased by 92.3%; Results > 14 cm also decreased (60.0% compared to 0.0%), percentage of result> 14 cm increased by 100,0%; Movement and stretching improved the spine (79.29o compared to 88.53o and 17.290 compared to 22.79o); Tilt left and right (23.790 compared to 30.29o) Tilt left and right to improve (33.59o compared to 41.07o).
I. DAT y^N OE
Dau that lu'ng la chu'ng benh rat thu'dng gap, tuy khdng gay nguy hiem tdi tinh mang nhuiig lam giam chat lu'dng eude sdng cua benh nhan, Trong y hpc co truyen, dau that lu'ng du'dc gpi la chirng yeu thdng. Benh lien quan nhieu tdi cong nang hoat ddng ciia tang can va than. ThiTe te lam sang chirng minh rang, mdt sd bai thuoc bo can than ed tac dung cai thien trieu chufng ciia eac benh nhan mac chu'ng dau tliat lu'ng. "Bo than trang du'dng hoan" xuat phat tu" bai thuoc cd phu'dng "HiJu quy hoan" trong Canh Nh?c toan thu", da du'dc tac gia Tru'dng Viet Binh danli gia day dii ve ddc tinh vdi ten "Hoi xuan hoan".
Ket qua nghien cirtj cho thay, bai thude cd tac dung ich than, sinh tlnh, tang cu'dng mien djch cho cd the.
Tuy nhien chu^ ed bat ky edng trinh nghien eiru nao danh gia tac dung ciia thude "Bo than
90
TAP CHl Y HOC VIET NAM TAP 459 - THANG 10 - SO 1 - 2017 trang du'dng hoan" tren cac benh nhan mac
chirng benh dau that lu'ng, tu'dng uYig vdi chuYig yeu thdng trong y hpc cd truyen. Vdi mong mudn tim hieu them ve tac dung eiia bai thuoc, tim them mdt lira chpn cho cae benh nhan dau theit lu'ng, chiing tdi tien hanh de tai vdi muc tieu: Danh gia kha nang phuc hoi van dgng cot sdng that iuhg cua thude "Bo than trang du'dng hoan"dbenh nhan mac chiing dau that lung the than du'dng hu".
IL OOI TU'DNG VA PHLTDNG PHAP NGHIEN CCTU 2 . 1 . Bai thuoc nghien cu'u: Bai thude "Bo than trang du'dng" (bai "HQ'u quy am" trong Canh Nhae toan thu^. Thue dja 24g, hoai sdn 16g, sdn thii 8g, ky tir 16g, cam thao tri'ch 16g, phu tir che 12g, nhuc que 12g, do trpng 16g.
Thude du'dc bao che du'di dang vien hoan cuTig do Khoa du'dc Benh vien Tue TTnh san suat, dat tieu diuan cd sd.
2.2. fija diem va thdi gian nghien cu'u Dja diem nghien cuXi: Benh vien Y Du'dc cd truyen Thanh phd Hd Chi Minh. Thdi gian nghien eiru: thang 10 nam 2011 den thang 1 nam 2012.
2.3. Doi tu'dng nghien cii'u: 30 benh nhan du'dc chan doan dau that lu'ng man tinh tuoi tCr 35 trd len, khdng phan biet gidi tinh, chu^ diing thude gi hoac da diTng cac thuoc dieu tri dau that luTig > 1 thang. Tieu chuan loai triT: dau that \dng do cac benh cap tinh.
2.4. PhuUng phap nghien cUw. Nghien eiru tien ciiU, thu' nghiem lam sang md, so sanh tru'dc va sau dieu trj: Benh nhan du'dc dung thude "Bo than trang du'dng hoan" ngay 10 vien, chia 2 lan udng sau an sang va tdi 30 phiit, diing thude lien bjc trong thdi gian 30 ngay. Thu thap cac chi tieu theo ddi: 10 ngay/l3n, bao gom: dp gian cot sdng that lulig, cac ehi sd gde van dpng cot song.
2.5. Phu'dng phap xijr iV so iieu: Sd lieu du'dc xi^ ly bang thuat toan thdng ke y sinh hpc vdi su" ho trd ciia phan mem thdng ke SPSS 15.0.
I I L K E T Q U A N G H l l N C C r U
Bang 3.1. Nghiem phap schober tai thdi diem Do
Nghiem phap Schober
< 11 cm 11-12 cm 12-13 cm 13-14 cm
> 14 cm Trunq binh
n 0 2 13 15 0
»/o 0.00 6.67 43.33 50.00 0.00 13,15 ± 1,87 Ket qua bang 3.1 cho thay: Tai thdi diem Do, mu'e dp van ddng cot sdng ban che nhieu.
Nghiem phap schober ket qua < 11cm va tren 14em la khdng ed tru'dng hdp nao; 13-14cm ty le eao nhat 50.0%; tiep den 12-13em la 43.33%'.
Trung binh 13,15 ± l,87em
Bang 3.2. Nghiem phap schober tai thdi diem Dig
Nghiem phap Schober
< 11cm 11-12 cm 12-13 cm 13-14 cm
> 14 cm Trunq binh
n 0 1 3 21 0
»/o 0.00 3.33 26.67 70.00 0.00 13,55 ± 1,42 Ket qua bang 3.2 cho thay: Sau 10 ngay dung
"bd than trang du'dng" (thdi diem Djo), kha nang van ddng cot sdng that lu'ng, ket qua 13-14cm ty le cao nhat 70.0%; tiep denl2-13em la 26.67%;
ket qua < l l c m va tren 14em la khdng ed tru'dng hdp nao; Trung binh 13,55 ± 1,42cm.
Bang 3.3. Nghiem phap schober tai tfidi diem D20
Nghiem phap Schober
< 11cm 11-12 cm 12-13 cm 13-14 cm
> 14 cm Trunq binh
n 0 0 5 17 8
»/o 0.00 0.00 16.67 56.67 26.67 13,95 ± 1,66 Ket qua bang 3.3 eho thay: Sau 20 ngay dung
"bd than trang du'dng" (thdi diem D20), kha nang van ddng cot sdng that lu'ng, ket qua 13-14em ty le cao niiat 56.67%; tiep denl2-13cm la 16.67%.; >14cm la 26.67%. Khdng cd tru'dng hdp nao < = 12cm; Trung binh 13,95 ± 1,66cm.
Bang 3.4, So sanh Nghiem phap schober tai thdi dl^m tru'dc vd sau dieu trj 15 ngay, 30 ngayfD„:D„.iiDj
N g h i e m p h a p Schober
< 11 cm 11-12 cm 12-13 cm
Do n 0 2 13
0.0
%
6.67 43.33
D,o n 0 1 8
0.0
%
3.33 26.67
D30 n 0 0 1
0.0
%
0.0 3.33
% giam/tanq D,s 0.0 50.0 38.4
Dm 0.0 100.0
92.3 P
Dfc ,s)>0.05
VIETNAM MEDICAL JOURNAL N°1 - OCTOBER - 2017
-^
13-14 cm
> 14 cm Trunq binh
15 0
50.0 0.0 13,15 ± 1,87
21 0
70.0 0.00 13,55 ± 1,42
11 18
36.67 60.0 14,25 ± 0,93
40.0 0.0
26.7 100.0
DCo: 30)<0.8P D(D; 1 S ) > 0 . C D(o ,n)<0.01
Ket qua bang 3.4 cho thay: Sau dieu tri 10 ngay so vdi tru'dc dieu trj, kha nang van ddng cot sdng that lu'ng, ket qua nghiem phap Schober ll-12em giam di (3.33% so vdi 6.
67%), phan tram ket qua nghiem phap Schober ll-12em giam 50.0%; ket qua 12-13em eting giam (26.67% so vdi 43.33%), phan tram ket qua 12-13em giam 38.4 phan tram; ket qua nghiem phap Schober l l - 1 2 c m giam 50.0%; ket qua 13-14cm tang len (70.0% so vdi 50.0%), phan tram ket qua 13-14cm tang 40.0%; Tuy nhien, sir khac nhau khdng cd y nghia, p>0,05.
Sau 30 ngay so vdi tru'dc dieu tri, kha nang van ddng cot sdng that luVig, ket qua nghiem phap Schober ll-12em giam di (0% so vdi 6.
67%), phan tram ket qua nghiem phap Schober ll-12cm giam 100.0%; ket qua 12-13em cung giam (3.33% so vdi 43.33%), phan tram ket qua 12-13cm giam 92.3%; ket qua 13-14em giam di (36.67% so vdi 50.0%), phan tram ket qua 13- 14cm giam 26.7%; ket qua >14cm cung giam (60.0% so vdi 0.0%), phan tram ket qua >14cm tang 100.0%; Sir khac nhau cd y nghTa, p<0,05.
Bang 3.5. Dien bien dgng tac gi'p duoi (^tsdng
Ket qua bang 3.6 dio thay; Ddng tac nghieng c5l:
sdng sang phai va trai cai thien c^n sau thdi gian di^
tri, tuy nhieu tang rd sau 30 ngay ( ^ u hi (23,79° so vdi 30,29°), sir khac biet cd y nghia p<0.05.
Bang 3.7. OlSn bien dgng tac nghiSng cot song
Thdi diem
Do
Din D20 DmPo.20 P0.30
Oon
Gap cot song 79,29 ± 4,30 81,54 ± 5,20 85,22 ± 5,05 88,53 ± 5,22
>0,05
<0,05
3 tacDuoi cot sonq 17,29 ± 3,31 18,27 ± 3,91 19,25 ± 4,19 22,79 ± 3,84
>0,05
<0,05
J<et qua bang 3.5 cho thay: Cu" ddng gap va duoi cot sdng cai thien dan sau thdi gian dieu t n , tuy nhieu tang rd sau 30 ngay dieu tri (79,29° so vdi 88,53° va 17,29° so vdi 22,79°), s'lT khac biet cdy nghTa p<0.05._Bang 3.6, Dien bien dgng tac nghieng cot sdng
Thdi diem Do
D,„
D,o
D,„
Po-io
Dong tac Nghieng sang 1 ben 23,79 ± 2,25 25,61 ± 3,55 28,10 ± 3,83 30,29 ± 2,79
> 0 , 0 5
< 0 , 0 5
Thdi diem Do D,o D20 Dm Po-20 P0-3D
Bong tac Xoay sang 1 b@n 33,59 ± 3,16 35,74 ± 4,36 37,89 ± 3,87 41,07 ± 3,79
>0,05
<0,05 Ket qua bang 3.7 cho thay: Ddng tac xoay cot sdng sang phai va trai cai thien dan sau thdi gla'r dieu tn deu tang len, tuy nhieu tang ro sau 30 ngay dieu tn (33,59° so vdi 41,07°), su" khac biet cd y nghTa p<0.05.
iV. BAN LU^N
Trong nghien eiru nay, ehiing tdi dung nghiem phap Schober la dai dien de danh gia tam van ddng khdp cot sdng that luhg. So lieu bieu hien d bang 3.1 cho thay van ddng cot song that luYig d cae benh nhan du'dc liTa chpn nghien cu'u ban che khdng nhieu.
Sau 10, 20 dimg thude "bd than trang du'dng", van dpng cot sdng that luVig cua cic benh nhan nghien eiiii tot d i n . So vdi thdi diem Do, sir khac biet ve kha nang van ddng khdp chi ed y nghTa sau 30 ngay diing thude (p<0,01) (ket qua ang 3.3). Nhu" vay cd the thay rang, kha nang cai thien mire dp han che van dpng cot sdng that lu'ng cua phu'dng phap dieu trj su" dung trong nghien cu'u nay la kha cham. Ket qua rtay phan nao du'dc giai thich bdi dac diem benh tat cua benh nhan nghien ciTu, day la cac benh nhan man tinh. Theo y hoc hien dai, thoai hi3a cot sdng la benh ly thiTc the, ban che van dpng trong thoai hda edt sdng that \dnq gay ra doi nguyen nhan: do bien dang khdp edt sdng vad?
dau. Chi ed phan han d i e van ddng do dau moi ed the cai thien du'dc. Vi vay, tac dung lam tang kha nang van dpng khdp edt sdng that iUng trong nghien culi nay chi thay rd khi tac dyng giam dau ciia phu'dng phap^da rd rang. Phain ban che van ddng khdp do ton thu'dng thut the rat khd cai thien, "bo' than trang du'dng" co kha
TAP CHi Y HOC VlgT NAM TAP 459 - THANG 10 - SO 1 - 2017 nang cai thien phan nay khdng, chung tdi can cd
nghien cii'u trong thdi gian dai va tren nhigu benh nhan hdn nij^.
Trong khoang 10 nam trd lai day, tai nu'de ta da cd mdt sd tac gia nghien cii'u ve tam boat ddng edt song that luYig. Cac cong trinh nay da tien hanh nghien ciTu mdt each khoa hoe tam hoat ddng edt sdng that lu'ng eiia ngu'di Viet Nam binh thu'dng va mdt sd tru'dng hdp benh iy viing cot sdng that \dng. Tuy vay eae nghien eiru sd lu'dng chu^ nhieu, ddi tu'dng nghien ciTu chuci phong phii, dac biet chda eo nhieu eac nghien eiru chuyen sau ve tam hoat ddng edt sdng that lung ciia cae benh nhan mac mdt chiTng benh ddn thuan viing edt sdng that lu'ng. Qua cae phan tich tren cae bang vira qua ta nhan thay rd tam hoat ddng cot sdng that lu'ng eua cac benh nhan thoai hoa cot sdng that lu'ng la ro nhu'ng khdng ldn.
Qua cac ket qua thu du'dc bang 3.4; 3.5; 3,6 d tren chiing tdi thay cac cd ddng eiia cot sdng that luYig deu tien trien tu'dng ddi tot sau thdi gian dieu trj. Tuy vay, neu so sanh vdi tac dung giam dau thi kha nang cai thien van ddng edt sdng that lutig dien ra cham va it hdn, sir khac biet chi ed y nghia sau khi udng thuoc 30 ngay.
Ket qua nay cd the du'dc ly giai bdi trong sd cac benh nhan dau that luYig ma chiing tdi liTa chpn nghien eiru da phan la benh ly man tinh, han clie van ddng edt sdng that luhg phan ldn do nguyen
nhan thut the, mdt phan it la dau. Benh nhan vdn sin cd ban che van ddng, trong ddt lien trien, benh nhan cd cam giac ijau hdn nen ban che van ddng ciJng tang len. Thude ed tac dung giam dau nen phan nao iam lang tam van ddng khdp.
V. KET LU^N
Qua ket qua nghien cu'u thu du'dc, chung tdi du:a ra ket sau: Bo than trang du'dng hoan ed tac dung cai thien tam van ddng edt sdng that lu'ng d nhij'ng benh nhan dau that iUng the than du'dng hu'. Nhiem phap Schober, cir ddng gap duoi edt sdng, ddng tac nghieng cot sdng sang phai, trai va ddng tac xoay edt sdng sang phai trai cai thien dan sau thdi gian dieu tri, tac dung rd ret sau 30 ngay dieu tri.
TAi UEU THAIVI KHAO
1. Tran Ngoc An (2002), "Dau viing that luhg", Benh thap khdp, Nha xuat ban Y hoc. Ha Noi, tr 374 - 395.
2. Do Xuan Hdp, Le Gia Vinh (1984), 7am hoat dgng khdp va y nghia cua no trong y hac, Y hoe thUe hanh. Ha Noi.
j i . Cao Thj Nhi (2002), "Dau cot song that lung".
Tap chf bac sy gia dmh, Nha xiiat ban Ha Ndi, tr.
40-43.
4. Le Trinh (2005), Dau cot sdng that luhg, Nha xuj't ban Y hoc, tr. 7-17.
3. Do Dinh Xuan p 0 0 2 ) , Nghien cuU tam hoat dgng cot song that iWng d ngUdi Viet Nam trudng thanh va mot so doi tudng benh ly vCing cot song that lUng, Luan an tien sy y hoc, Hgc vien Quan Y.
NGUY c a TRAM CAM V A MOT SO YEU TO LIEN QUAN 6* SINH VIEN KHOI KY THUAT NAM I TRU'ffNG DAI HOC KY THUAT Y TE HAI DU'ffNG
N A M HOC 2 0 1 6 - 2 0 1 7
T r ^ n T h i M i n h T a r n * TOM TAT
Muc tieu: Xac dinh ti le nguy eO tram cam (NCTC) va mdt so yeu td lien quan d sinh vien Tru'dng Oai hoc Ky thuat Y te Hai Du'dng nam hoc 2016 - *2017.
Phu'dng phap nghien edu md ta cat ngang cd phan b'ch. Ket qua: nghien eiru 273 sinh vien nam nhat khoi ky thuat tru'dng Dai hoe ky thuat Y te Hai Du'cfng nam hgc 2016-2017 thS'y sinh vien cd NCTC chiem ty l | 11,4% va sinh vien khdng co NCTC chiem ti le 88,5%.Trong do ty le sinh vien ed NCTC d chuyen nganh xet nghiem chiem ft" le 14,3%, d hinh anh
*Tru'dng Dai hgc Ky diuat Y teHai Dddng Chju trach nhiem chi'nh: Tran Thj Minh Tam Email: [email protected] Ngay nhan bai: 12.7.2017 Ngay phan bien khoa hgc: 4.9.2017 Ngay duyet bai: 13.9.2017
chiem ti le 8,1% va sd sinh vien khoa PHCN 11,8%.
NCTC cd mdi lien quan vdi gia dinh, ban be, xa hgi:
Khi gap kho khan trong viec tim ban mdi thi sinh vien cd NCTC cao han 1,3 lan sinh vien khong gap kho khan. NCTC phu thuoc ve ban than sinh vien: sinh vien giam siit siTc khde cd NCTC eao gap 2,875 lan so vdi nhifng sinh vien khoe manh. Khi tang_ ap lUe hoe hanh, sinh vien cd NCTC cao gap 30 lan sinh vien khac.NCrC va yeu to stress tir moi trUdng sdng va lam viee: Khi mdi trUdng song Ion xdn, biTa bai thi ti le cd NCTC eao qao 13,5 lan sinh vien khac.
Td khoa: Nguy cd tram cam d smh vien SUMMARY
RISKS FOR MAJOR DEPRESSIVE DISORDER AND ITS RELATING FACTORS
AMONG FIRST - YEAR STUDENTS AT MEDICAL TECHNOLOGY UNIT OF HAI DUONG MEDICAL TECHNICAL UNIVERSITY
