体外冲击波治疗非钙化性冈上肌肌腱炎疗效观察  被引量:8

Clinical observation of extracorporeal shock wave therapy for chronic non-calcific tendinopathy of the supraspinatus

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作  者:谷玉静[1] 林松[2] 冯晓东[1] 

机构地区:[1]河南中医学院第一附属医院康复中心,郑州450000 [2]香港理工大学

出  处:《中国骨与关节杂志》2014年第9期657-660,共4页Chinese Journal of Bone and Joint

摘  要:目的观察体外冲击波治疗非钙化性冈上肌肌腱炎的临床疗效。方法 2011年4月至2013年4月,我科收治的非钙化性冈上肌肌腱炎患者53例,平均年龄(40.42±1.33)岁,分为治疗组26例和对照组27例。两组均采用红外线基础治疗,治疗组在基础治疗上进行小剂量体外冲击波治疗,对照组在基础治疗上采用冲击波安慰治疗。治疗前和治疗后1个月、3个月,两组均采用Constant-Murley肩关节功能评定法(constant-murley score,CMS)进行功能评定。结果两组均进行了至少3个月的随访,无1例在治疗过程中出现严重的副作用。治疗组各指标由治疗前的疼痛(2.08±0.80)分、日常生活能力(8.65±1.65)分、关节活动度(12.77±3.10)分、肌力(10.38±1.13)分和CMS(33.88±4.08)分分别增加到治疗后1个月的(8.00±0.89)分、(12.96±1.40)分、(20.58±5.68)分、(13.50±1.24)分、(54.04±5.17)分,治疗后3个月增加更显著,分别为(11.08±1.47)分、(17.96±1.11)分、(30.46±4.43)分、(15.92±2.47)分、(75.42±6.35)分,各指标及CMS总分治疗后1个月、3个月分别和治疗前比较,差异均有统计学意义(P<0.05);但对照组各指标及CMS总分治疗后1个月和3个月均较治疗前变化不大,差异均无统计学意义(P>0.05)。治疗后1个月两组组间比较,除肌力外,其它各指标和CMS总分的差异均有统计学意义(P<0.05);治疗后3个月,两组组间比较,各指标及CMS总分差异均有统计学意义(P<0.05)。结论小剂量体外冲击波治疗非钙化性冈上肌肌腱炎效果确切,能明显减轻患者疼痛、提高患者日常生活能力、增加患者关节活动度及肌力,对改善肩关节整体功能具有促进作用,值得临床推广。Objective To observe the clinical effects of extracorporeal shock wave therapy ( ESWT ) for chronic non-calcific tendinopathy of the supraspinatus.Methods From April 2011 to April 2013, 53 patients with chronic non-calciifc tendinopathy of the supraspinatus were adopted, whose average age was ( 40.42±1.33 ) years old. They were randomly divided into treatment group (n=26 ) and control group (n=27 ). The patients in both groups received infrared ray therapy. Besides, the patients in the treatment group received low-dose ESWT and the patients in the control group accepted placebo therapy. The Constant-Murley score ( CMS ) was used to assess the improvement of the shoulder function in both groups before the treatment and at 1 and 3months after the treatment.Results The patients in both groups were followed up for at least 3 months, and no severe side effects were noticed during the treatment. In the treatment group, the scores of Visual Analogue Scale ( VAS ), activity of daily living ( ADL ) scale, range of motion ( ROM ) scale, muscle strength grading scale and CMS were ( 2.08±0.80 ) points, ( 8.65±1.65 ) points, ( 12.77±3.10 ) points, ( 10.38±1.13 ) points and ( 33.88±4.08 ) points before the treatment, which were increased to ( 8.00±0.89 ) points, ( 12.96±1.40 ) points, ( 20.58±5.68 ) points, ( 13.50±1.24 ) points and ( 54.04±5.17 ) points at 1 month after the treatment and ( 11.08±1.47 ) points, ( 17.96±1.11 ) points, ( 30.46±4.43 ) points, ( 15.92±2.47 ) points and ( 75.42±6.35 ) points at 3 months after the treatment. When all the scores stated above and the total CMS score before the treatment were compared with that at 1 and 3 months after the treatment respectively, statistically signiifcant differences existed (P〈0.05 ). However, when all the scores stated above before the treatment were compared with that at 1 and 3 months after the treatment respectively in the control group, no statisticall

关 键 词:高能量冲击波 体外光化学疗法 肌腱病 康复 冈上肌 

分 类 号:R686[医药卫生—骨科学]

 

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