体外冲击波治疗肱骨外上髁炎的临床研究  

A clinical study of extracorporeal shock wave for treatment of humeral external epicondylitis

作　　者：刘欢 周涛斌 李振 李谱友 刘小敏[1] LIU Huan;ZHOU Taobin;LI Zhen;LI Puyou;LIU Xiaomin(The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi,China)

机构地区：[1]江西中医药大学附属医院

出　　处：《中医正骨》2019年第10期7-11,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察体外冲击波(extracorporeal shock wave,ESW)治疗肱骨外上髁炎的临床疗效。方法:将符合要求的72例(86肘)肱骨外上髁炎患者随机分为2组,37例(43肘)采用ESW治疗(ESW组),35例(43肘)采用局部封闭治疗(局部封闭组);每周治疗1次,3周为1个疗程,共治疗1个疗程。分别于治疗前、治疗结束时及治疗结束后3个月、6个月比较2组患者肘部疼痛视觉模拟量表(visualanaloguescale,VAS)评分和上肢功能障碍(disabilitiesofthearm,shoulderandhand,DASH)评分,并于治疗结束时比较2组患者的综合疗效。结果:①肘部疼痛VAS评分。时间因素和分组因素存在交互效应(F=18.692,P=0.000);2组患者肘部疼痛VAS评分比较,差异有统计学意义,即存在分组效应(F=-3.278,P=0.002);2组患者治疗前后不同时间点肘部疼痛VAS评分的差异有统计学意义,即存在时间效应(F=13.674,P=0.000);2组患者肘部疼痛VAS评分随时间均呈下降趋势,但2组的下降趋势不完全一致[(7.50±2.70)分,(3.80±2.10)分,(3.20±2.30)分,(2.50±1.30)分,F=45.824,P=0.000;(7.60±2.80)分,(5.70±3.20)分,(5.80±3.70)分,(5.60±2.70)分,F=4.003,P=0.009];治疗前,2组患者的肘部疼痛VAS评分比较,差异无统计学意义(t=-0.169,P=0.867);治疗结束时和治疗结束后3个月、6个月,ESW组的肘部疼痛VAS评分均低于局部封闭组(t=-3.255,P=0.002;t=-3.913,P=0.000;t=-6.784,P=0.000)。②DASH评分。时间因素和分组因素存在交互效应(F=24.893,P=0.000);2组患者DASH评分比较,差异有统计学意义,即存在分组效应(F=-4.271,P=0.000);2组患者治疗前后不同时间点DASH评分的差异有统计学意义,即存在时间效应(F=86.341,P=0.000);2组患者DASH评分随时间均呈下降趋势,但2组的下降趋势不完全一致[(50.31±9.72)分,(31.15±5.56)分,(23.77±4.02)分,(20.05±5.12)分,F=186.136,P=0.000;(49.57±8.31)分,(40.01±7.18)分,(32.09±5.96)分,(30.19±6.36)分,F=68.196,P=0.000];治疗前,2组患者的DASH评分比较,差异无统计学意�Objective: To observe the clinical curative effects of extracorporeal shock wave( ESW) therapy for treatment of humeral external epicondylitis. Methods: Seventy-two patients( 86 elbows) with humeral external epicondylitis were enrolled in the study and were randomly divided into 2 groups. Thirty-seven patients( 43 elbows) were treated with ESW therapy( ESW group),while thirty - five patients ( 43 elbows) were treated with local blocking therapy( local blocking group). The both therapies were performed once a week for one course of treatment,3 weeks for each course. The elbow pain visual analogue scale( VAS) scores and disabilities of the arm,shoulder and hand ( DASH) scores were compared between the 2 groups before treatment,at the end of treatment and at 3 and 6 months after the end of the treatment respectively,and the total curative effects were compared between the 2 groups at the end of treatment. Results: There was interaction between time factor and group factor in elbow pain VAS scores( F = 18. 692,P = 0. 000). There was statistical difference in elbow pain VAS scores between the 2 groups,in other words,there was group effect( F =- 3. 278,P = 0. 002). There was statistical difference in elbow pain VAS scores between different timepoints before and after treatment,in other words,there was time effect( F = 13. 674,P = 0. 000). The elbow pain VAS scores presented a time - dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency( 7. 50 +/- 2. 70,3. 80 +/- 2. 10,3. 20 +/- 2. 30,2. 50 +/- 1. 30 points,F = 45. 824,P = 0. 000;7. 60 +/- 2. 80,5 . 70 +/- 3. 20,5 . 80 +/- 3. 70,5 . 60 +/- 2. 70 points,F = 4. 003,P = 0. 009). There was no statistical difference in elbow pain VAS scores between the 2 groups before the treatment( t =- 0. 169,P = 0. 867). The elbow pain VAS scores were lower in ESW group compared to local blocking group at the end of treatment and at 3 and 6 months after the end of the treatment( t =- 3. 255,P = 0. 002;t =- 3. 913,

关 键 词：网球肘 肱骨外上髁炎 体外冲击波 封闭疗法 临床试验 

分 类 号：R681.7[医药卫生—骨科学]