不同能级体外冲击波治疗仪对老年人足跟痛近期临床疗效比较  

Comparison the short-term clinical effects of different energy extracorporeal shock wave therapy instruments on elderly patients with calcaneodynia

作　　者：胡晓红 郄淑燕[1] 刘晓磊[2] HU Xiao-hong;QIE Shu-yan;LIU Xiao-lei(Department of Rehabilitation,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China;Department of Orthopedics,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院康复科,北京100144 [2]首都医科大学附属北京康复医院骨科,北京100144

出　　处：《生物医学工程与临床》2021年第6期720-724,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的研究不同能级体外冲击波治疗仪在治疗老年足跟痛中的近期疗效。方法选择2018年6月至2020年6月收治的93例老年足跟痛患者,其中男性57例,女性36例;年龄60~75岁,平均年龄65.73岁;病程0.6~6.0年,平均病程3.48年。随机将其分为A组、B组及C组。A组采用低能级体外冲击波,B组采用中能级体外冲击波,C组采用类固醇药物局部封闭治疗,比较3组治疗后晨起第一步足跟疼痛程度、踝-足功能、检测患者治疗前后俯卧位跟骨-筋膜结合处足底筋膜厚度、患者治疗满意度及足底筋膜炎复发情况。结果3组治疗前晨起第一步足跟疼痛视觉模拟量表(VAS)评分差异无统计学意义(P>0.05);3组治疗1周及1个月后,晨起第一步足跟疼痛VAS评分均较同组治疗前显著下降(P<0.01);治疗1个月后,VAS评分A组<B组<C组(1.19分±0.32分<1.65分±0.35分<2.31分±0.26分)(P<0.01),且3组两两间差异有统计学意义(P<0.05)。3组治疗前美国矫形外科足踝协会(AOFAS)量表评分差异无统计学意义(P>0.05),治疗1周及1个月后,3组AOFAS量表评分均较同组治疗前显著上升(P<0.01);治疗1个月后,AOFAS量表评分A组>B组>C组(91.06分±16.65分>85.04分±14.63分>81.63分±12.36分)(P<0.01),且3组两两间差异有统计学意义(P<0.05)。治疗前,3组足底筋膜厚度差异无统计学意义(P>0.05),治疗1周及1个月后,3组足底筋膜厚度均较同组治疗前显著下降(P<0.01);治疗1个月后,足底筋膜厚度A组<B组<C组,差异有统计学意义(3.74 mm±0.94 mm<4.06 mm±0.84 mm<4.36 mm±0.73 mm)(P<0.05),且3组两两间差异有统计学意义(P<0.05)。治疗后6个月C组复发率显著高于A组、B组(22.58%vs 3.23%、6.45%),差异有统计学意义(χ^(2)=6.947,P<0.05)。结论与超声引导下药物治疗相比,体外冲击波在治疗足底筋膜炎中的效果更好,而低能级体外冲击波治疗效果优于中能级,建议临床采用低能级体外冲击波治疗老年足跟痛。Objective To investigate short-term efficacy of different energy extracorporeal shock wave therapy instruments on elderly patients with calcaneodynia.Methods From June 2018 to June 2020,a total of 93 elderly patients with calcaneodynia were enrolled,which included 57 males and 36 females,aged 60-75 years old with mean age of 65.73 years old.The course of disease was 0.6-6.0 years with mean course of 3.48 years.All of them were randomly divided into 3 groups according to different treatment.Group A performed low-energy extracorporeal shock wave therapy;group B performed medium-energy extracorporeal shock wave therapy,and group C performed local steroid therapy.The heel pain on first step in the morning,ankle-foot function after treatment,plantar fascia thickness in the prone,patient satisfaction and recurrence rate of plantar fasciitis before and after treatment were compared.Results There was no significant difference in visual analogue scale(VAS)scores of heel pain on first step in the morning before treatment among 3 groups(P>0.05),and all groups showed significant decreased at 1-week and 1-month post treatment than before(P<0.01).The VAS score was group A<group B<group C(1.19 scores±0.32 scores<1.65 scores±0.35 scores<2.31 scores±0.26 scores)(P<0.01)at 1 month post treatment,and there were statistical differences among 3 groups(P<0.05).There was no significant difference in American Orthopaedic Foot and Ankle Association(AOFAS)scale scores before treatment among 3 groups(P>0.05).After treatment for 1-week and 1-month,the AOFAS scale scores were significantly higher than those before treatment in the same group(P<0.01);AOFAS score was group A>group B>group C(91.06 scores±16.65 scores>85.04 scores±14.63 scores>81.63 scores±12.36 scores)(P<0.01)at 1-month post treatment,and there were statistical differences among 3 groups(P<0.05).There was no significant difference in plantar fascia thickness before treatment among 3 groups(P>0.05).After treatment for 1-week and 1-month,it was significantly lower than befo

关 键 词：体外冲击波 低能量 老年足跟痛 类固醇药物局部封闭治疗 近期疗效 

分 类 号：R686.3[医药卫生—骨科学] R681.8[医药卫生—外科学]