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[日间护理单位强化训练疗法对轴性脊柱关节炎的影响]

[The effect of intensified training therapy on axial spondylarthritis in day care units].

作者信息

Schneidereit T, Delia D, Schmeiser T, Buehring B

机构信息

Bergisches Rheuma-Zentrum, Krankenhaus St. Josef, Bergstr. 6-12, 42105, Wuppertal, Deutschland.

Praxis Rheumatologie im Veedel, Köln, Deutschland.

出版信息

Z Rheumatol. 2024 Apr;83(3):210-216. doi: 10.1007/s00393-023-01333-6. Epub 2023 Mar 9.

DOI:10.1007/s00393-023-01333-6
PMID:36894623
Abstract

BACKGROUND

Day care units are an essential part of psychiatric treatment in Germany. In rheumatology they are also regularly used. Axial spondylarthritis (axSpA) is an inflammatory rheumatic disease that causes pain, diminished quality of life, limitations in activities of daily living and ability to work, especially if insufficiently treated. The multimodal rheumatologic complex treatment with at least 14 days of inpatient care is an established tool to control exacerbated disease activity. The feasibility and effect of an equivalent treatment in a day care setting has not yet been evaluated.

METHODS

The effect of a therapy in a day care unit comparable to the inpatient multimodal rheumatologic complex treatment was investigated using clinically established patient reported outcomes (NAS pain, FFbH, BASDAI, BASFI).

RESULTS

Selected subgroups of axSpA patients can routinely and effectively be treated in day care units. Intensified multimodal as well as nonintensified treatment forms lead to reduced disease activity. Additionally, compared to nonintensified treatment, the intensified multimodal treatment approach leads to significantly reduced pain, and disease-related and functional limitations in daily life.

CONCLUSION

If available, treatment in a day care unit can complement the established inpatient treatment modalities in selected axSpA patients. In cases with high disease activity and suffering, intensified multimodal treatment should be preferred due to better outcomes.

摘要

背景

日间护理单元是德国精神科治疗的重要组成部分。在风湿病学领域也经常使用。轴性脊柱关节炎(axSpA)是一种炎症性风湿性疾病,会导致疼痛、生活质量下降、日常生活活动受限以及工作能力受限,尤其是在治疗不充分的情况下。至少14天的住院多模式风湿病综合治疗是控制疾病活动加剧的既定方法。尚未评估在日间护理环境中进行等效治疗的可行性和效果。

方法

使用临床确定的患者报告结局(NAS疼痛、FFbH、BASDAI、BASFI)研究在日间护理单元中与住院多模式风湿病综合治疗相当的一种治疗方法的效果。

结果

axSpA患者的选定亚组可以在日间护理单元中常规且有效地接受治疗。强化多模式以及非强化治疗形式均可降低疾病活动度。此外,与非强化治疗相比,强化多模式治疗方法可显著减轻疼痛以及与疾病相关的日常生活功能限制。

结论

如果可行,日间护理单元的治疗可以补充选定的axSpA患者已有的住院治疗方式。在疾病活动度高且痛苦的情况下,由于效果更好,应首选强化多模式治疗。

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本文引用的文献

1
Diagnosis and treatment of adult-onset Still's disease: a concise summary of the German society of rheumatology S2 guideline.成人斯蒂尔病的诊断与治疗:德国风湿病学会S2指南简明摘要
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Z Rheumatol. 2022 Aug;81(6):472-481. doi: 10.1007/s00393-022-01190-9. Epub 2022 Apr 1.
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Clinical, Economic, and Humanistic Burden Associated With Delayed Diagnosis of Axial Spondyloarthritis: A Systematic Review.轴性脊柱关节炎延迟诊断相关的临床、经济和人文负担:一项系统综述
Rheumatol Ther. 2020 Mar;7(1):65-87. doi: 10.1007/s40744-020-00194-8. Epub 2020 Jan 21.
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Evaluation of a special concept of physical therapy in spondyloarthritis: German multimodal rheumatologic complex treatment for spondyloarthritis.评价一种脊柱关节炎物理治疗的特殊理念:德国多模式风湿性综合治疗脊柱关节炎。
Clin Rheumatol. 2020 May;39(5):1513-1520. doi: 10.1007/s10067-019-04887-6. Epub 2020 Jan 8.
6
2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.2019 年美国风湿病学会/脊柱关节炎协会/脊柱关节炎研究和治疗网络关于治疗强直性脊柱炎和非放射学中轴型脊柱关节炎的建议更新。
Arthritis Rheumatol. 2019 Oct;71(10):1599-1613. doi: 10.1002/art.41042. Epub 2019 Aug 22.
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Axial spondyloarthritis.中轴型脊柱关节炎。
Lancet. 2017 Jul 1;390(10089):73-84. doi: 10.1016/S0140-6736(16)31591-4. Epub 2017 Jan 20.
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2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis.2016 年更新的 ASAS-EULAR 中轴型脊柱关节炎管理推荐。
Ann Rheum Dis. 2017 Jun;76(6):978-991. doi: 10.1136/annrheumdis-2016-210770. Epub 2017 Jan 13.
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Rheumatol Int. 2011 Jun;31(6):795-800. doi: 10.1007/s00296-010-1381-x. Epub 2010 Mar 10.