腓肠肌内侧头腱膜松解和体外冲击波治疗跖筋膜炎疗效对比研究  

Study of proximal medial gastrocnemius release versus extracorporeal shock wave for chronic plantar fasciitis

作　　者：李丙岩 刘兵兵[1] 王长军[1] 孔亮[1] 侯建勇 LI Bingyan;LIU Bingbing;WANG Changjun(Department of Orthopedics,Beijing Jingmei Group General Hospital,Beijing 102300,China)

机构地区：[1]北京京煤集团总医院骨科,北京市102300

出　　处：《河北医药》2024年第18期2776-2779,2783,共5页Hebei Medical Journal

基　　金：北京京煤集团总医院院级科研基金项目(编号:2021-06)。

摘　　要：目的比较腓肠肌内侧头腱膜松解术与体外冲击波对慢性跖筋膜炎的治疗效果。方法采用前瞻性随机对照研究,选取2021年8月至2023年9月北京京煤集团总医院收治的100例单侧慢性跖筋膜炎患者作为研究对象,采用随机数字表法将其分为腱膜松解组与体外冲击波组,每组50例。腱膜松解组采用腓肠肌内侧头腱膜松解术治疗,体外冲击波组接受体外冲击波治疗。比较2组患者治疗前、后视觉模拟评分(VAS)、踝关节背伸角度(ROM)、美国骨科足踝外科协会踝-后足评分(AOFAS)、足底筋膜厚度以及平衡能力。结果治疗后,腱膜松解组VAS评分明显低于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组踝关节背伸ROM大于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组AOFAS评分高于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组的足底筋膜厚度低于体外冲击波组,差异有统计学意义(P<0.05)。腱膜松解组前侧的星偏移平衡测试法(star excursion balance test,SEBT)检测结果与体外冲击波组比较,差异无统计学意义(P>0.05);其余方向检测结果相较于体外冲击波组均增加(P<0.05)。结论相较于体外冲击波治疗,腓肠肌内侧头腱膜松解术能有效缓解患者疼痛程度、扩大其ROM,改善踝关节功能,降低足底筋膜厚度,提高平衡能力。Objective To study the therapeutic effects of proximal medial gastrocnemius release(PMGR)versus extracorporeal shock wave(ESW)for chronic plantar fasciitis(CPF).Methods This was a prospective randomized controlled study involving 100 patients with unilateral CPF admitted to Beijing Jingmei Group General Hospital from August 2021 to September 2023.They were randomly assigned in a 1:1 radio to receive either PMGR(PMGR group)or ESW(ESW group).The aim was to compare visual analogue scale(VAS),range of motion(ROM)of ankle joint extension,the American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-Hindfoot Scale,plantar fascia thickness(PFT),balance ability.Results After treatment,PMGR group had significantly lower VAS scores,significantly greater ROM of ankle joint extension,significantly higher AOFAS scores,significantly lower PFT than the ESW group(all P<0.05).The results for star excursion balance test(SEBT)showed that the anterior side of PMGR group were comparable to those of ESW group(P>0.05),and the other sides in PMGR group were significantly increased compared to ESW group(P<0.05).Conclusion Compared with ESW,PMGR can effectively alleviate patient pain,expand ROM,improve ankle joint function,reduce PFT,and enhance balance ability.

关 键 词：腓肠肌内侧头腱膜松解 体外冲击波 慢性跖筋膜炎 视觉模拟评分 美国骨科足踝外科协会踝-后足评分 

分 类 号：R684.77[医药卫生—骨科学]