遵循软组织外科学理论放散式冲击波治疗肱骨外上髁炎的疗效观察  

Efficacy of radial shock wave guided by soft tissue surgery theory in the treatment of lateral epicondylitis

作　　者：李兴财 王帅[2] 陈凯雄 刘荣国[2] Li Xingcai;Wang Shuai;Chen Kaixiong;Liu Rongguo(Department of Anesthesiology,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Pain Medicine,Fujian Provincial Hospital,Shengli Clinical College of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院麻醉科,福州350001 [2]福建医科大学省立临床医学院福建省立医院疼痛科,福州350001

出　　处：《中华医学杂志》2021年第43期3564-3568,共5页National Medical Journal of China

摘　　要：目的探讨放散式冲击波治疗(RSWT)肱骨外上髁炎(LE)的疗效。方法收集福建省立医院疼痛门诊2017年12月至2019年10月就诊的LE患者54例,采用随机数字表法分为试验组和对照组各27例。试验组先行肩胛背面(冈下三肌压痛点)RSWT,后行肘外侧区域压痛点RSWT。对照组行肘外侧区域压痛点RSWT。两组患者均治疗4次,每周1次。比较两组患者治疗前、治疗后1周、1个月和3个月疼痛数字评分(NRS)、病患网球肘评价(PRTEE)以及无痛握力(PFG)的差异。结果试验组患者治疗前、治疗后1周、1个月和3个月的NRS评分分别为(6.5±1.6)、(4.0±1.1)、(3.9±1.5)、(1.7±1.1)分,对照组分别为(6.2±1.4)、(3.8±1.3)、(4.2±1.2)、(2.6±1.2)分,两组患者在治疗后不同时点的NRS评分均较治疗前显著下降(均P<0.05)。两组患者治疗后不同时点的PRTEE、无痛握力均较治疗前明显改善(均P<0.05)。在治疗结束后3个月,试验组PRTEE、NRS分别为(18±11)和(1.7±1.1)分,均低于对照组的(25±11)和(2.6±1.2)分(均P<0.05)。结论RSWT可改善LE患者的疼痛和功能;根据软组织外科学理论选择肘外侧联合肩胛背面RSWT优于单纯肘外侧RSWT。Objective To explore the efficacy of radial shock wave therapy(RSWT)for lateral epicondylitis(LE).Methods A total of 54 cases suffering from LE from Department of Pain Medicine of Fujian Provincial Hospital between December 2017 to October 2019 were randomly assigned to experimental group(n=27)and control group(n=27).Subjects in the experimental group were applied with RSWT in the lateral elbow area plus scapular back area,while patients in control group were applied with RSWT only in the lateral elbow area.Patients in both groups underwent RSWT one session per week for four weeks.Numeric rating scale(NRS),pain-free grip(PFG)test and patient-rated tennis elbow evaluation(PRTEE)in both groups were evaluated and compared at the pre-treatment,one week,one month and three months after treatment.Results The NRS scores at pre-treatment,one week,one month and three months after treatment in experimental group were 6.5±1.6,4.0±1.1,3.9±1.5,1.7±1.1,respectively,while those in control group were 6.2±1.4,3.8±1.3,4.2±1.2,2.6±1.2,respectively.Compared with those at pre-treatment,the NRS scores in both groups were significantly decreased at one week,one month and three months after treatment(all P<0.05).The PRTEE and PFG results showed significant improvement after treatment(all P<0.05).The NRS scores and PRTEE at three months after treatment in the experimental group were 18±11,1.7±1.1,respectively,which were significantly lower than those in the control group(25±11,2.6±1.2,respectively)(both P<0.05).Conclusions RSWT exerts a beneficial effect on LE.Guided by the soft tissue surgery theory,RSWT in the lateral elbow area plus scapular back area produces better pain reduction and functional improvement compared with RSWT only in the lateral elbow area.

关 键 词：高能量冲击波 肱骨外上髁炎 软组织外科学 

分 类 号：R681.7[医药卫生—骨科学]