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整骨手法治疗对囊性纤维化肺部加重期住院患者的影响:对肺功能测定结果以及患者呼吸、焦虑和疼痛评估的影响

Osteopathic manipulative treatment for inpatients with pulmonary exacerbations of cystic fibrosis: effects on spirometry findings and patient assessments of breathing, anxiety, and pain.

作者信息

Swender David A, Thompson Gina, Schneider Kristen, McCoy Karen, Patel Alpa

机构信息

From Oaklawn Hospital in Marshall, Michigan (Dr Swender); Nationwide Children's Hospital in Columbus, Ohio (Drs Thompson, McCoy, and Patel); and Ohio Pediatrics, Inc, in Dayton (Dr Schneider).

From Oaklawn Hospital in Marshall, Michigan (Dr Swender); Nationwide Children's Hospital in Columbus, Ohio (Drs Thompson, McCoy, and Patel); and Ohio Pediatrics, Inc, in Dayton (Dr Schneider)

出版信息

J Am Osteopath Assoc. 2014 Jun;114(6):450-8. doi: 10.7556/jaoa.2014.095.

Abstract

CONTEXT

Osteopathic manipulative treatment (OMT) has been studied in patients with various respiratory diseases. However, to the authors' knowledge, no studies have assessed the efficacy of OMT in patients with cystic fibrosis (CF).

OBJECTIVE

To evaluate pulmonary function and perceptions of breathing, anxiety, and pain of CF patients who receive OMT in addition to standard inpatient management of pulmonary exacerbation.

METHODS

In a single-blind randomized controlled trial, we assessed adult patients with a history of CF who were admitted to the hospital because of pulmonary exacerbation. Participants were randomly assigned to receive a daily standardized protocol of OMT or sham therapy. Both groups also received standard treatment for CF. Spirometry and questionnaire data (self-assessment of breathing, pain, and anxiety level) were collected before the first OMT or sham therapy session and after the final session.

RESULTS

A total of 33 patients were included in the study: 16 in the OMT group and 17 in the sham therapy group. Improvements in spirometric parameters were observed in both the OMT and the sham therapy groups, with no statistically significant differences found between the groups. More patients in the OMT group than in the sham therapy group had questionnaire response patterns that indicated their breathing had improved during the study period (15 of 16 vs 8 of 16, respectively). No differences were found between groups for perceived improvement of pain and anxiety.

CONCLUSION

In the current study, CF patients who received OMT did not demonstrate statistically significant differences in pre- and posttreatment spirometry findings compared with CF patients who received sham therapy. Questionnaire findings suggest that OMT may affect CF patients' perception of overall quality of breathing. Additional studies are needed to assess the clinical use of OMT in patients with CF.

摘要

背景

整骨手法治疗(OMT)已在患有各种呼吸系统疾病的患者中进行了研究。然而,据作者所知,尚无研究评估OMT对囊性纤维化(CF)患者的疗效。

目的

评估除了肺部加重期的标准住院治疗外,接受OMT的CF患者的肺功能以及对呼吸、焦虑和疼痛的感受。

方法

在一项单盲随机对照试验中,我们评估了因肺部加重期入院的成年CF患者。参与者被随机分配接受每日标准化的OMT方案或假治疗。两组患者均接受CF的标准治疗。在第一次OMT或假治疗之前和最后一次治疗之后收集肺活量测定数据和问卷调查数据(呼吸、疼痛和焦虑水平的自我评估)。

结果

共有33名患者纳入研究:OMT组16名,假治疗组17名。OMT组和假治疗组的肺活量测定参数均有改善,两组之间未发现统计学上的显著差异。与假治疗组相比OMT组中有更多患者的问卷回答模式表明在研究期间他们的呼吸有所改善(分别为16名中的15名和16名中的8名)。两组在疼痛和焦虑的感知改善方面未发现差异。

结论

在本研究中,与接受假治疗的CF患者相比,接受OMT的CF患者在治疗前后的肺活量测定结果上没有显示出统计学上的显著差异。问卷调查结果表明,OMT可能会影响CF患者对整体呼吸质量的感受。需要进一步的研究来评估OMT在CF患者中的临床应用。

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