超声引导下腓肠肌脉冲射频治疗跟痛症的临床疗效及安全性研究  

THE EFFICACY AND SAFETY OF MANAGEMENT OF PLANTAR HEEL-PAIN BY APPLICATION OF ULTRASOUND-GUIDED PULSED RADIOFREQUENCY IN GASTROCNEMIUS

作　　者：叶乐[1] 朱浩[2] 张金源[1] 方洪伟 郑拥军 王祥瑞[1] YE Le;ZHU Hao;ZHANG Jing-Yuan;FANG Hong-Wei;ZHENG Yong-Jun;WANG Xiang-Rui(Department of Pain Management,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Anesthesiology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Pain Management,Huadong Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海交通大学医学院附属仁济医院疼痛科,上海200025 [2]上海交通大学医学院附属仁济医院麻醉科,上海200025 [3]上海复旦大学附属华东医院疼痛科,上海200040

出　　处：《中国疼痛医学杂志》2018年第3期198-206,共9页Chinese Journal of Pain Medicine

基　　金：上海闵行区科委研究项目"线粒体生物发生异常致肌筋膜疼痛的机制研究"

摘　　要：目的:目前临床仍旧缺乏针对顽固性跟痛症的治疗方案。我们研究在超声引导下腓肠肌脉冲射频治疗(UG-PRF)能否安全有效地缓解跟痛症。方法:这项研究比较UG-PRF组与假手术组治疗100例跟痛症病人。主要评价指标包括:足部健康状态问卷量表(FHSQ-疼痛评分)和"第一步"疼痛在视觉模拟量表(visual analogue scale,VAS)上测量(VAS-"第一步"疼痛)。次要评价指标包括:FHSQ-足部功能和足部健康评分,以及健康调查简表(SF-36)来进行评估。分别在治疗后的第3和6个月评估相关结果。结果:随访中,两组比较,UG-PRF组在3或6个月时,具有更高的FHSQ-疼痛评分[分别比假手术组增加了20.0(P<0.0001)和17.9(P=0.001)],且具有更低的VAS-"第一步"疼痛评分[分别为26.1(P<0.0001)和14.3(P=0.01)]。术后第3和第6个月时,UG-PRF组比假手术组,有更高的FHSQ足功能评分和足部健康评分(P<0.05)。且假手术组的SF-36得分为10.8(P=0.042)和10.4(P=0.044),均低于UG-PRF组。两组治疗期间均没有观察到严重的并发症。结论:超声引导下腓肠肌脉冲射频治疗(UG-PRF)能够安全和有效的治疗跟痛症。Objective:Nowadays,there is still no good treatment for plantar heel-pain.We studied whether the radiofrequency treatment(UG-PRF)of the gastrocnemius is safe and effective to relieve plantar heel pain.Methods:In this study,100 patients with plantar heel pain were randomly divided into UG-PRF group and sham treatment group.We compared two groups at pre-operation(baseline)and 3 or 6 months of post-treatment.Outcome measures included the pain subscale of the Foot Health Status Questionnaire(FHSQ-pain),"first step"pain as measured on a visual analogue scale(VAS-"first-step"pain),the FHSQ-foot function and general foot health,and health related quality of life[using the Short Form-36 questionnaire(SF-36)to assessed].Results:The results showed the efficacy of UG-PRF in terms of pain management,as reflected by higher FHSQ-pain score(increased by 20.0(P<0.0001)and 17.9(P=0.001)compared with the sham treatment at 3 and 6 months,respectively)and lower VAS-"first-step"pain(reduced by 26.1(P<0.0001)and 14.3(P=0.01)compared with the sham group at 3 or 6 months,respectively.The FHSQ-foot function and FHSQ-general foot health were increased by the UG-PRF(P<0.05,vs sham treatment at 3 or 6 months).The SF-36 physical component score in the sham group was 10.8(P=0.042)and 10.4(P=0.044)lower than the UG-PRF group at 3 or 6 months,respectively.No severe complications were observed.Conclusions:We conclude that the UG-PRF is both safe and efficacious in managing plantar heel pain.

关 键 词：跟痛症 触发点 脉冲射频 超声引导 随机对照试验 

分 类 号：R686.3[医药卫生—骨科学]