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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.

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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