体外冲击波多探头联合应用治疗肩关节周围炎的临床研究  

A clinical study of multi-probe extracorporeal shock wave therapy for treatment of periarthritis of shoulder

作　　者：吴国林[1] 陈红卫[1] 黄洪斌[1] 陈超丽[1] 林忠凯 任安龙 何元诚[2] 黄民锋[2] WU Guolin;CHEN Hongwei;HUANG Hongbin;CHEN Chaoli;LIN Zhongkai;REN Anlong;HE Yuancheng;HUANG Minfeng(Yiwu Central Hospital,Yiwu 322000,Zhejiang,China;Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning 530011,Guangxi,China)

机构地区：[1]义乌市中心医院,浙江义乌322000 [2]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《中医正骨》2020年第9期18-22,34,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省医学会临床科研基金项目(2016ZYC-A100);义乌市公益性科技计划项目(2016-S-16)。

摘　　要：目的:探讨体外冲击波多探头联合应用治疗肩关节周围炎的临床疗效。方法:将60例符合要求的肩关节周围炎患者随机分为2组,每组30例。常规冲击波组应用普通探头(R15)行体外冲击波治疗,多探头冲击波组在普通探头(R15)治疗基础上,联合应用另外2种型号的探头(A6和DI15)进行治疗。2组均每隔6 d治疗1次,共治疗5次。分别于治疗前和治疗结束后测定患者的肩关节活动度、Constant-Murley肩关节评分及日本骨科学会(Japanese Orthopedic Association,JOA)肩关节疾患治疗评分。结果:①肩关节活动度。治疗前2组患者的肩关节前屈、外展、内旋及外旋活动度比较,组间差异均无统计学意义(74.03°±16.57°,73.87°±16.73°,t=0.039,P=0.969;68.80°±16.23°,68.50°±16.52°,t=0.071,P=0.944;49.07°±5.99°,49.03°±6.13°,t=0.210,P=0.983;34.83°±2.90°,34.73°±2.88°,t=0.134,P=0.894);治疗结束后2组患者的前屈、外展、内旋及外旋活动度均较治疗前增大(前屈:t=-70.026,P=0.000;t=-56.174,P=0.000;外展:t=-28.108,P=0.000;t=-54.735,P=0.000;内旋:t=-34.561,P=0.000;t=-36.690,P=0.000;外旋:t=-21.341,P=0.000;t=-21.548,P=0.000),多探头冲击波组的前屈、外展、内旋及外旋活动度均大于常规冲击波组(127.87°±18.28°,138.43°±16.92°,t=2.465,P=0.017;90.93°±14.21°,101.83°±15.38°,t=2.852,P=0.006;68.93°±4.08°,72.10°±3.21°,t=3.343,P=0.001;49.37°±6.37°,61.73°±9.53°,t=5.909,P=0.000)。②Constant-Murley肩关节评分。治疗前2组患者的Constant-Murley肩关节评分比较,差异无统计学意义[(45.80±10.11)分,(44.93±10.09)分,t=2.012,P=0.054];治疗结束后2组患者的评分均较治疗前增大(t=-40.360,P=0.000;t=-52.535,P=0.000),多探头冲击波组的评分大于常规冲击波组[(70.33±9.59)分,(77.10±10.41)分,t=-13.179,P=0.000]。③JOA肩关节疾患治疗评分。治疗前2组患者的JOA肩关节疾患治疗评分比较,差异无统计学意义[(54.17±12.98)分,(54.10±12.93)分,t=0.348,P=0.730];Objective:To explore the clinical curative effects of multi-probe extracorporeal shock wave therapy(ESWT)for treatment of periarthritis of shoulder.Methods:Sixty patients with periarthritis of shoulder were enrolled in the study and were randomly divided into conventional ESWT group and multi-probe ESWT group,30 cases in each group.All patients in the 2 groups were treated with conventional probe(R15)ESWT,moreover,the patients in multi-probe ESWT group were treated with another two probes(A6 and DI15)ESWT.The ESWT was performed on patients for consecutive 5 times with a 6-day rest-insertion between times.The shoulder range of motion(ROM),Constant-Murley shoulder scores and Japanese Orthopedic Association(JOA)shoulder disease treatment scores were measured and compared between the 2 groups before the treatment and after the end of the treatment respectively.Results:There was no statistical difference in shoulder ROM including anteflexion,abduction,inward rotation and outward rotation between the 2 groups before the treatment(74.03+/-16.57 vs 73.87+/-16.73 degrees,t=0.039,P=0.969;68.80+/-16.23 vs 68.50+/-16.52 degrees,t=0.071,P=0.944;49.07+/-5.99 vs 49.03+/-6.13 degrees,t=0.210,P=0.983;34.83+/-2.90 vs 34.73+/-2.88 degrees,t=0.134,P=0.894).The shoulder ROM,including anteflexion,abduction,inward rotation and outward rotation,increased after the end of the treatment compared to pretreatment in the 2 groups(anteflexion:t=-70.026,P=0.000;t=-56.174,P=0.000;abduction:t=-28.108,P=0.000;t=-54.735,P=0.000;inward rotation:t=-34.561,P=0.000;t=-36.690,P=0.000;outward rotation:t=-21.341,P=0.000;t=-21.548,P=0.000),and were greater in multi-probe ESWT group compared to conventional ESWT group(127.87+/-18.28 vs 138.43+/-16.92 degrees,t=2.465,P=0.017;90.93+/-14.21 vs 101.83+/-15.38 degrees,t=2.852,P=0.006;68.93+/-4.08 vs 72.10+/-3.21 degrees,t=3.343,P=0.001;49.37+/-6.37 vs 61.73+/-9.53 degrees,t=5.909,P=0.000).There was no statistical difference in Constant-Murley shoulder scores between the 2 groups before the treatment(45.80+/-10.

关 键 词：肩凝症 体外冲击波疗法 临床试验 

分 类 号：R686[医药卫生—骨科学]