اثر مکمل یاری توام عصاره زردچوبه ، فلفل سیاه و زنجبیل بر میزان درد و عملکرد بیماران مبتلا به استئوآرتریت مزمن زانو

ﻣﻘﺪﻣﻪ: اﺳﺘﺌﻮآرﺗﺮﯾﺖ ﺷﺎﯾﻊﺗﺮﯾﻦ ﺑﯿﻤﺎری ﻣﻔﺼﻠﯽ اﺳﺖ ﮐﻪ ﻣﯽﺗﻮاﻧﺪ ﺑﻪ درد ﻣﺰﻣﻦ و ﻧﺎﺗﻮاﻧﯽ ﺷﺪﯾﺪ ﺑﯿﻤﺎر ﻣﻨﺠﺮ ﺷﻮد. ﺑﺴﯿﺎری از ﭘﮋوﻫﺸﮕﺮان ﺑﻪ دﻧﺒﺎل روشﻫﺎی درﻣﺎﻧﯽ ﺟﺪﯾﺪی ﻫﺴﺘﻨﺪ ﮐﻪ ﺿﻤﻦ اﺛﺮﺑﺨﺶ ﺑﻮدن، ﻋﻮارض ﺟﺎﻧﺒﯽ ﮐﻤﺘﺮی داﺷﺘﻪ ﺑﺎﺷﺪ. ﮐﻮرﮐﻮﻣﯿﻦ ﻣﺎده ﻣﺆﺛﺮ زردﭼﻮﺑﻪ از ﺗﺮﮐﯿﺒﺎت ﻃﺒﯿﻌﯽ دارای ﺧﻮاص ﺿﺪ اﻟﺘﻬﺎﺑﯽ ﺑﻮده و ﻧﻘﺶ ﻣﻬﻤﯽ در ﻣﺤﺎﻓﻈﺖ از ﻣﻔﺎﺻﻞ در ﻣﻘﺎﺑﻞ ﻋﻮاﻣﻞ ﻣﺨﺮب دارد. ﺟﯿﻨﺠﺮول و ﭘﺎﯾﭙﺮﯾﻦ ﻧﯿﺰ ﺑﻪ ﺗﺮﺗﯿﺐ ﺑﻪ ﻋﻨﻮان ﻣﺎده ﻣﺆﺛﺮ زﻧﺠﺒﯿﻞ و ﻓﻠﻔﻞ ﺳﯿﺎه اﺣﺘﻤﺎﻻً ﻣﯽﺗﻮاﻧﻨﺪ ﻣﻨﺠﺮ ﺑﻪ ﺗﻘﻮﯾﺖ و ﺗﺪاوم اﺛﺮ ﮐﻮرﮐﻮﻣﯿﻦ ﺷﻮﻧﺪ. در اﯾﻦ ارﺗﺒﺎط، ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ اﺛﺮ ﻣﮑﻤﻞﯾﺎری ﺗﻮام ﻋﺼﺎره زردﭼﻮﺑﻪ، ﻓﻠﻔﻞ ﺳﯿﺎه و زﻧﺠﺒﯿﻞ ﺑﺮ ﻣﯿﺰان درد و ﻋﻤﻠﮑﺮد ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ اﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺰﻣﻦ زاﻧﻮ در ﻣﻘﺎﯾﺴﻪ ﺑﺎ داروی ﻧﺎﭘﺮوﮐﺴﻦ اﻧﺠﺎم ﺷﺪ. روشﻫﺎ: در ﭘﮋوﻫﺶ ﺣﺎﺿﺮ 60 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ اﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺰﻣﻦ زاﻧﻮ ﺑﺎ درﺟﻪ 2 و 3 ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. اﻓﺮاد ﺑﻪ ﻃﻮر ﺗﺼﺎدﻓﯽ ﺟﻬﺖ درﯾﺎﻓﺖ ﻋﺼﺎره زردﭼﻮﺑﻪ، زﻧﺠﺒﯿﻞ و ﻓﻠﻔﻞ ﺳﯿﺎه (ﮐﭙﺴﻮل ﻣﯿﮑﺴﻮدﯾﻦ) ﯾﺎ ﮐﭙﺴﻮل ﻧﺎﭘﺮوﮐﺴﻦ ﺑﻪ ﺻﻮرت روزاﻧﻪ و ﺑﻪ ﻣﺪت ﭼﻬﺎر ﻫﻔﺘﻪ، در دو ﮔﺮوه ﺟﺪاﮔﺎﻧﻪ ﺗﺨﺼﯿﺺ داده ﺷﺪﻧﺪ. ﻧﻤﺮه درد و ﻋﻤﻠﮑﺮد ﺑﯿﻤﺎران اﺑﺘﺪا و اﻧﺘﻬﺎی ﻣﻄﺎﻟﻌﻪ ارزﯾﺎﺑﯽ ﺷﺪ و ﻣﯿﺰان درد آنﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻣﻘﯿﺎس ﺧﻄﯽ- ﺑﺼﺮی درد(:vas visual analogue scale) اﻧﺪازهﮔﯿﺮی ﮔﺮدﯾﺪ. ﻫﻤﭽﻨﯿﻦ ﺑﻪ ﻣﻨﻈﻮر ارزﯾﺎﺑﯽ ﺗﻐﯿﯿﺮات ﻋﻤﻠﮑﺮد از ﭘﺮﺳﺸﻨﺎﻣﻪ the western ontario and mcmaster universities osteoarthritis index( womac) اﺳﺘﻔﺎده ﺷﺪ. درﯾﺎﻓﺖ ﻏﺬاﯾﯽ (ﯾﺎدآﻣﺪ 24 ﺳﺎﻋﺘﻪ) ﻧﯿﺰ اﺑﺘﺪا، ﻣﯿﺎﻧﻪ و اﻧﺘﻬﺎی ﻣﻄﺎﻟﻌﻪ ﺛﺒﺖ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪﻫﺎ: از ﺑﯿﻦ 60 ﺑﯿﻤﺎر داوﻃﻠﺐ، 30 ﻧﻔﺮ در ﮔﺮوه ﻣﯿﮑﺴﻮدﯾﻦ و 30 ﻧﻔﺮ در ﮔﺮوه ﻧﺎﭘﺮوﮐﺴﻦ ﭘﮋوﻫﺶ را ﺑﻪ ﭘﺎﯾﺎن رﺳﺎﻧﺪﻧﺪ. ﺑﺮ ﻣﺒﻨﺎی ﻧﺘﺎﯾﺞ، ﮐﺎﻫﺶ در ﻧﻤﺮه درد (0/001=p) و ﻋﻤﻠﮑﺮد ﺑﯿﻤﺎران (0/001=p) در دو ﮔﺮوه ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداری ﮐﺎﻫﺶ ﯾﺎﻓﺘﻪ ﺑﻮد؛ اﻣﺎ ﺗﻔﺎوﺗﯽ در ﻣﯿﺰان ﮐﺎﻫﺶ ﺑﺎ ﻣﻘﺎﯾﺴﻪ ﺑﯿﻦ ﮔﺮوﻫﯽ ﻣﺸﺎﻫﺪه ﻧﺸﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮی: ﻧﺘﺎﯾﺞ ﻧﺸﺎن دادﻧﺪ ﮐﻪ ﻣﺼﺮف ﮐﭙﺴﻮل ﻣﯿﮑﺴﻮدﯾﻦ ﺑﻪ ﺻﻮرت دو ﺑﺎر در روز ﺑﻪ ﻣﺪت ﭼﻬﺎر ﻫﻔﺘﻪ، ﻣﺸﺎﺑﻪ ﺑﺎ داروی ﻧﺎﭘﺮوﮐﺴﻦ ﻣﯽﺗﻮاﻧﺪ ﻣﻨﺠﺮ ﺑﻪ ﺑﻬﺒﻮد ﻧﻤﺮه درد و ﻋﻤﻠﮑﺮد ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ اﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺰﻣﻦ زاﻧﻮ ﮔﺮدد.

The effect of curcuma, black peper, ginger on pain and performance of the patient with chronic knee osteoarthritis in comparison with Naproxen drug

Introduction: Training has an important role in decreasing accidents and increasing safety level of workplaces. The aim of this study is to compare the effect of inperson training and virtual training on using personal protection equipment among the staff in an open stone quarry.Method: In this study, intermediary of training type has been carried out on three different groups (control, in person training, and virtual training) on 75 numbers of staff in an open stone quarry in 2018. The training content was compiled by researcher in virtual and inperson types and then confirmed by the experts. Data of personal protection equipmentusage in workplace were gathered by questionnair before and after trainig. Data were analysed by statistical tests including K2, dependant t, paired t, and variance analysis.Results: There has been no significant difference between groups before trainig the use of personal protection equipment. After training, findings showed a significant difference in personal protection equipment average usage among the staff. After intermediary, The ratio of using safety helmet and mask was increased among virtual and in person groups rather than control group.Conclusion: This study findings have shown that inperson training and virtual training methods are effective in using the personal protection equipment in both groups and have increased safetybehaviors. It seems that using virtual training as alternative or complementary method for traditional methods can be an appropriate approach for retraining and improveing quarry staff aposs safety and selfcare behaviour