84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]劉歡,周濤斌,李振,等.體外沖擊波治療肱骨外上髁炎的臨床研究[J].中醫(yī)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.
點(diǎn)擊復(fù)制

體外沖擊波治療肱骨外上髁炎的臨床研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年10期
頁碼:
7-11
欄目:
臨床研究
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:
劉歡; 周濤斌; 李振; 李譜友; 劉小敏
(江西中醫(yī)藥大學(xué)附屬醫(yī)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
關(guān)鍵詞:
網(wǎng)球肘;  肱骨外上髁炎;  體外沖擊波;  封閉療法;  臨床試驗(yàn)
Keywords:
tennis elbow;  humeral external epicondylitis;  extracorporeal shock wave;  blocking therapy;  clinical trial
摘要:
目的:觀察體外沖擊波(extracorporeal shock wave,ESW)治療肱骨外上髁炎的臨床療效。方法:將符合要求的72例(86肘)肱骨外上髁炎患者隨機(jī)分為2組,37例(43肘)采用ESW治療(ESW組),35例(43肘)采用局部封閉治療(局部封閉組); 每周治療1次,3周為1個療程,共治療1個療程。分別于治療前、治療結(jié)束時及治療結(jié)束后3個月、6個月比較2組患者肘部疼痛視覺模擬量表(visual analogue scale,VAS)評分和上肢功能障礙(disabilities of the arm,shoulder and hand,DASH)評分,并于治療結(jié)束時比較2組患者的綜合療效。結(jié)果:①肘部疼痛VAS評分。時間因素和分組因素存在交互效應(yīng)(F=18.692,P=0.000); 2組患者肘部疼痛VAS評分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=-3.278,P=0.002); 2組患者治療前后不同時間點(diǎn)肘部疼痛VAS評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=13.674,P=0.000); 2組患者肘部疼痛VAS評分隨時間均呈下降趨勢,但2組的下降趨勢不完全一致[(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]; 治療前,2組患者的肘部疼痛VAS評分比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.169,P=0.867); 治療結(jié)束時和治療結(jié)束后3個月、6個月,ESW組的肘部疼痛VAS評分均低于局部封閉組(t=-3.255,P=0.002; t=-3.913,P=0.000; t=-6.784,P=0.000)。②DASH評分。時間因素和分組因素存在交互效應(yīng)(F=24.893,P=0.000); 2組患者DASH評分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=-4.271,P=0.000); 2組患者治療前后不同時間點(diǎn)DASH評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=86.341,P=0.000); 2組患者DASH評分隨時間均呈下降趨勢,但2組的下降趨勢不完全一致[(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]; 治療前,2組患者的DASH評分比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.379,P=0.705); 治療結(jié)束時和治療結(jié)束后3個月、6個月,ESW組的DASH評分均低于局部封閉組(t=-6.398,P=0.000; t=-7.589,P=0.000; t=-8.144,P=0.000)。③綜合療效。治療結(jié)束時,ESW組臨床控制21肘、顯效11肘、有效7肘、無效4肘,局部封閉組臨床控制10肘、顯效15肘、有效8肘、無效10肘; ESW組患者的綜合療效優(yōu)于局部封閉組(Z=-2.455,P=0.014)。結(jié)論:采用ESW和局部封閉治療肱骨外上髁炎,均能緩解疼痛、促進(jìn)肘關(guān)節(jié)功能恢復(fù),但前者療效優(yōu)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.

參考文獻(xiàn)/References:

[1] ZWERUS E L,SOMFORD M P,MAISSAN F,et al.Physical examination of the elbow,what is the evidence?A systematic literature review[J].Br J Sports Med,2018,52(19):1253-1260.
[2] KROSLAK M,MURRELL G A C.Surgical treatment of lateral epicondylitis:a prospective,randomized,double-blinded,placebo-controlled clinical trial[J].Am J Sports Med,2018,46(5):1106-1113.
[3] COOMBES B K,CONNELLY L,BISSET L,et al.Economic evaluation favours physiotherapy but not corticosteroid injection as a first-line intervention for chronic lateral epicondylalgia:evidence from a randomised clinical trial[J].Br J Sports Med,2016,50(22):1400-1405.
[4] 鞏浩然,呂杭州,王振龍,等.體外沖擊波治療踝關(guān)節(jié)創(chuàng)傷性關(guān)節(jié)炎[J].中醫(yī)正骨,2018,30(2):63-64.
[5] 王和鳴,黃桂成.中醫(yī)骨傷科學(xué)[M].北京:中國中醫(yī)藥出版社,2012:8. 中醫(yī)正骨2019年10月第31卷第10期 J Trad Chin Orthop Trauma,2019,Vol.31,No.10(總731) (總732)中醫(yī)正骨2019年10月第31卷第10期 J Trad Chin Orthop Trauma,2019,Vol.31,No.10
[6] ARMSTRONG A D,HUBBARD MC.美國骨科醫(yī)師協(xié)會骨科疾病診療教程[M].王巖,譯.中國醫(yī)師協(xié)會骨科醫(yī)師分會,2017:299.
[7] 蔣協(xié)遠(yuǎn),王大偉.骨科臨床療效評價標(biāo)準(zhǔn)[M].北京:人民衛(wèi)生出版社,2005:123-124.
[8] DIXON D,JOHNSTON M,QUEEN M,et al.The Disabilities of the Arm,Shoulder and Hand Questionnaire(DASH)can measure the impairment,activity limitations and participation restriction constructs from the International Classification of Functioning,Disability and Health(ICF)[J].BMC Musculoskelet Disord,2008,9:114.
[9] 鄭筱萸.中藥新藥臨床研究指導(dǎo)原則(試行)[M].北京:中國醫(yī)藥科技出版社,2002:349-353.
[10] 周政東.三聯(lián)療法治療肱骨外上髁炎[J].中醫(yī)正骨,2019,31(2):56-57.
[11] SHILLITO M,SOONG M,MARTIN N.Radiographic and clinical analysis of lateral epicondylitis[J].J Hand Surg Am,2017,42(6):436-442.
[12] DESCATHA A,ALBO F,LECLERC A,et al.Lateral epicondylitis and physical exposure at work?A review of prospective studies and meta-analysis[J].Arthritis Care Res(Hoboken),2016,68(11):1681-1687.
[13] 嚴(yán)偉,譚訓(xùn)香,姜紅江,等.體外沖擊波聯(lián)合血小板裂解液局部注射治療難治性肱骨外上髁炎[J].中醫(yī)正骨,2016,28(8):52-55.
[14] LIAO C D,XIE G M,TSAUO J Y,et al.Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders:a meta-analysis of randomized controlled trials[J].BMC Musculoskelet Disord,2018,19(1):278.
[15] KOSTENKO E V,ZUEV D S,ZAITSEVA T N.The role of extracorporeal shock wave therapy in the combined restorative treatment of the patients presenting with myofascial pain syndrome[J].Vopr Kurortol Fizioter Lech Fiz Kult,2018,95(4):62-68.
[16] KVALVAAG E,BROX J I,ENGEBRETSEN K B,et al.Effectiveness of radial extracorporeal shock wave therapy(rESWT)when combined with supervised exercises in patients with subacromial shoulder pain:a double-masked,randomized,sham-controlled trial[J].Am J Sports Med,2017,45(11):2547-2554.
[17] BEYAZAL M S,DEVRIMSEL G.Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis[J].J Phys Ther Sci,2015,27(12):3755-3758.
[18] GOLLWITZER H,SAXENA A,DIDOMENICO L A,et al.Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis:a randomized,controlled multicenter study[J].J Bone Joint Surg Am,2015,97(9):701-708.
[19] LOHRER H,NAUCK T,DORN-LANGE N V,et al.Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures[J].Foot Ankle Int,2010,31(1):1-9.
[20] BUCHBINDER R,GREEN S E,YOUD J M,et al.Systematic review of the efficacy and safety of shock wave therapy for lateral elbow pain[J].J Rheumatol,2006,33(7):1351-1363.
[21] 中國研究型醫(yī)院學(xué)會沖擊波醫(yī)學(xué)專業(yè)委員會,國際沖擊波醫(yī)學(xué)學(xué)會中國部.骨肌疾病體外沖擊波療法中國專家共識(第2版)[J].中國醫(yī)學(xué)前沿雜志(電子版),2017,9(2):25-33.
[22] CROWTHER M A,BANNISTER G C,HUMA H,et al.A prospective,randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow[J].J Bone Joint Surg Br,2002,84(5):678-679.
[23] YOUNG P,HOMLAR K C.Extreme postinjection flare in response to intra-articular triamcinolone acetonide(Kenalog)[J].Am J Orthop(Belle Mead NJ),2016,45(3):E108-111.
[24] VICENZINO B,BRITT H,POLLACK A J,et al.No abatement of steroid injections for tennis elbow in Australian General Practice:a 15-year observational study with random general practitioner sampling[J].PLoS One,2017,12(7):e0181631.

相似文獻(xiàn)/References:

[1]伍輝國,江克羅,張文正,等.針刀經(jīng)皮松解聯(lián)合復(fù)方當(dāng)歸注射液局部注射治療 肱骨外上髁炎[J].中醫(yī)正骨,2015,27(09):38.
[2]嚴(yán)偉,譚訓(xùn)香,姜紅江,等.體外沖擊波聯(lián)合血小板裂解液局部注射治療難治性肱骨外上髁炎[J].中醫(yī)正骨,2016,28(08):52.
[3]吳樂彬,于阿春.三聯(lián)療法治療肱骨外上髁炎[J].中醫(yī)正骨,2019,31(11):57.
[4]李言杰,韓銘明,王艷春,等.基于超聲影像的肱骨外上髁炎分型及其中醫(yī)臨床應(yīng)用[J].中醫(yī)正骨,2024,36(05):69.
[5]陳紅燕,趙偉兒,方煜麗,等.針刀治療肱骨外上髁炎合并肱橈關(guān)節(jié)滑膜嵌頓[J].中醫(yī)正骨,2015,27(05):27.
[6]周政東.三聯(lián)療法治療肱骨外上髁炎[J].中醫(yī)正骨,2019,31(02):56.
[7]何江濤,郭華,李眾毅,等.自體富血小板血漿痛點(diǎn)注射與小針刀松解治療肱骨外上髁炎的對比研究[J].中醫(yī)正骨,2019,31(03):5.
　HE Jiangtao,GUO Hua,LI Zhongyi,et al.A comparative study of injection of autologous platelet rich plasma in pain spots versus releasing with small knife needle for treatment of external humeral epicondylitis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(10):5.
[8]葉志孟,彭琳瑞,鄭華江.肌內(nèi)效貼貼扎聯(lián)合耳穴貼壓治療肱骨外上髁炎[J].中醫(yī)正骨,2019,31(08):57.

備注/Memo

備注/Memo:
通訊作者:劉小敏 E-mail:[email protected](收稿日期:2019-08-02 本文編輯:時紅磊)
更新日期/Last Update: 2019-10-15