[1]刘欢,周涛斌,李振,等.体外冲击波治疗肱骨外上髁炎的临床研究[J].中医正骨,2019,31(10):7-11.
　LIU Huan,ZHOU Taobin,LI Zhen,et al.A clinical study of extracorporeal shock wave for treatment of humeral external epicondylitis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(10):7-11.
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体外冲击波治疗肱骨外上髁炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年10期
页码:
7-11
栏目:
临床研究
出版日期:
2019-10-20

文章信息/Info

Title:
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
(江西中医药大学附属医院,江西 南昌 330006)
Author(s):
LIU Huan; ZHOU Taobin; LI Zhen; LI Puyou; LIU Xiaomin
The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi,China
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
Keywords:
tennis elbow;  humeral external epicondylitis;  extracorporeal shock wave;  blocking therapy;  clinical trial
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(visual analogue scale,VAS)评分和上肢功能障碍(disabilities of the arm,shoulder and hand,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,差异无统计学意义(t=0.379,P=0.705); 治疗结束时和治疗结束后3个月、6个月,ESW组的DASH评分均低于局部封闭组(t=-6.398,P=0.000; t=-7.589,P=0.000; t=-8.144,P=0.000)。③综合疗效。治疗结束时,ESW组临床控制21肘、显效11肘、有效7肘、无效4肘,局部封闭组临床控制10肘、显效15肘、有效8肘、无效10肘; ESW组患者的综合疗效优于局部封闭组(Z=-2.455,P=0.014)。结论:采用ESW和局部封闭治疗肱骨外上髁炎,均能缓解疼痛、促进肘关节功能恢复,但前者疗效优于后者。
Abstract:
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 witheach 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,P=0.000; t=-6.784,P=0.000).There was interaction between time factor and group factor in DASH scores(F=24.893,P=0.000).There was statistical difference in DASH scores between the 2 groups,in other words,there was group effect(F=-4.271,P=0.000).There was statistical difference in DASH scores between different timepoints before and after treatment,in other words,there was time effect(F=86.341,P=0.000).The DASH 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(50.31+/-9.72,31.15+/-5.56,23.77+/-4.02,20.05+/-5.12 points,F=186.136,P=0.000; 49.57+/-8.31,40.01+/-7.18,32.09+/-5.96,30.19+/-6.36 points,F=68.196,P=0.000).There was no statistical difference in DASH scores between the 2 groups before the treatment(t=0.379,P=0.705).The DASH 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=-6.398,P=0.000; t=-7.589,P=0.000; t=-8.144,P=0.000).At the end of the treatment,21 elbows were controlled,11 good,7 fair and 4 poor in ESW group; while 10 elbows were controlled,15 good,8 fair and 10 poor in local blocking group.The ESW group surpassed local blocking group in the total clinical curative effects(Z=-2.455,P=0.014).Conclusion:Both ESW therapy and local blocking therapy can relieve the pain and improve the elbow function recovery in the treatment of humeral external epicondylitis,however,the former surpasses the latter in clinical curative effects.

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备注/Memo

备注/Memo:
通讯作者:刘小敏 E-mail:13807058668@163.com(收稿日期:2019-08-02 本文编辑:时红磊)
更新日期/Last Update: 2019-10-15