Noll Donald R, Degenhardt Brian F, Fossum Christian, Hensel Kendi
Academic Medicine Inc, 800 W Jefferson St, Kirksville, MO 63501-1443, USA.
J Am Osteopath Assoc. 2008 Sep;108(9):508-16.
Pneumonia in elderly patients is a major public health concern because of greater morbidity and mortality and longer hospital stays relative to younger populations. Based on the premise that osteopathic manipulative treatment (OMT) is beneficial in the management of pulmonary infections, the Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) was designed as a prospective randomized controlled trial to evaluate the efficacy of OMT as an adjunct to the current pharmacologic treatment of elderly patients hospitalized for pneumonia. The protocol developed for MOPSE has its origins in early osteopathic medical literature at a time when effective antibiotic therapy was unavailable and osteopathic physicians relied on physical examination and empiric reasoning to develop treatment strategies and OMT techniques to improve host defenses against pneumonia. The present paper reviews the early osteopathic medical literature to identify the reasoning behind the OMT techniques that are the basis for the design of the MOPSE protocol. Likewise, the contemporary medical literature relevant to the protocol is reviewed. Finally, a description of the study design and the OMT and light touch (sham) protocols used in MOPSE are provided.
老年患者的肺炎是一个重大的公共卫生问题，因为与年轻人群相比，其发病率和死亡率更高，住院时间更长。基于整骨手法治疗（OMT）对肺部感染的治疗有益这一前提，多中心老年整骨肺炎研究（MOPSE）被设计为一项前瞻性随机对照试验，以评估OMT作为目前因肺炎住院的老年患者药物治疗辅助手段的疗效。为MOPSE制定的方案起源于早期的整骨医学文献，当时尚无有效的抗生素治疗方法，整骨医生依靠体格检查和经验推理来制定治疗策略和OMT技术，以增强宿主对肺炎的防御能力。本文回顾早期整骨医学文献，以确定作为MOPSE方案设计基础的OMT技术背后的推理。同样，也对与该方案相关的当代医学文献进行了回顾。最后，介绍了MOPSE的研究设计以及所使用的OMT和轻触（假手术）方案。
