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[1]豐凡翔,張鑫,劉付龍,等.體外沖擊波療法治療早中期距骨骨軟骨損傷的臨床研究[J].中醫(yī)正骨,2023,35(01):25-29,35.
　FENG Fanxiang,ZHANG Xin,LIU Fulong,et al.Clinical efficacy of extracorporeal shock wave therapy on early to mid-stage osteochondral lesions of the talus[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(01):25-29,35.
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體外沖擊波療法治療早中期距骨骨軟骨損傷的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年01期
頁碼:
25-29,35
欄目:
臨床研究
出版日期:
2023-01-20

文章信息/Info

Title:
Clinical efficacy of extracorporeal shock wave therapy on early to mid-stage osteochondral lesions of the talus
作者:
豐凡翔; 張鑫; 劉付龍; 楊濟(jì)嶸; 肖依誠; 李軍明
(四川省骨科醫(yī)院,四川 成都 610041)
Author(s):
FENG Fanxiang; ZHANG Xin; LIU Fulong; YANG Jirong; XIAO Yicheng; LI Junming
Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
沖擊波;  距骨骨軟骨損傷;  磁共振成像;  成像; 三維;  臨床試驗(yàn)
Keywords:
shock wave;  osteochondral lesion of the talus;  magnetic resonance imaging;  imaging; three-dimensional;  clinical trial
摘要:
目的:評價(jià)體外沖擊波療法(extracorporeal shock wave therapy,ESWT)治療早中期距骨骨軟骨損傷(osteochondral lesion of the talus,OLT)的臨床療效。方法:將60例符合要求的HeppleⅠ期至Ⅲ期OLT患者隨機(jī)分為常規(guī)組和沖擊波組,每組30例。入組后2組患者均采用針刺、超聲波治療、踝周肌力訓(xùn)練、口服雙氯芬酸鈉腸溶片及限制患肢負(fù)重等常規(guī)療法治療,沖擊波組在此基礎(chǔ)上輔以ESWT治療,2組均治療5周。比較2組患者治療前及治療結(jié)束后2個(gè)月的踝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、美國足與踝關(guān)節(jié)協(xié)會(American Orthopedic Foot and Ankle Society,AOFAS)踝與后足評分及病灶體積。結(jié)果:治療前2組患者的踝關(guān)節(jié)疼痛VAS評分、AOFAS踝與后足評分及病灶體積比較,組間差異均無統(tǒng)計(jì)學(xué)意義(Z=0.139,P=0.709; Z=0.351,P=0.554; Z=0.184,P=0.668)。治療結(jié)束后2個(gè)月,2組患者的踝關(guān)節(jié)疼痛VAS評分均較治療前降低[(5,2)分,(5,2)分,Z=-2.828,P=0.005;(5,2)分,(3,1)分,Z=-4.902,P=0.000],AOFAS踝與后足評分均較治療前提高[(69.50,11.75)分,(72.00,11.25)分,Z=-4.450,P=0.000;(68.50,11.50)分,(78.50,13.75)分,Z=-4.793,P=0.000]; 沖擊波組治療結(jié)束后2個(gè)月的病灶體積較治療前減小[(1.77,0.76)cm3,(1.27,0.71)cm3,Z=-4.783,P=0.000],常規(guī)組治療前后病灶體積的差異無統(tǒng)計(jì)學(xué)意義[(1.74,0.77)cm3,(1.79,0.54)cm3,Z=-0.160,P=0.873]。沖擊波組治療結(jié)束后2個(gè)月的踝關(guān)節(jié)疼痛VAS評分低于常規(guī)組(Z=37.890,P=0.000),AOFAS踝與后足評分高于常規(guī)組(Z=3.944,P=0.047),病灶體積小于常規(guī)組(Z=15.134,P=0.000)。結(jié)論:采用ESWT治療早中期OLT,有助于緩解踝關(guān)節(jié)疼痛、改善踝關(guān)節(jié)功能、控制病灶進(jìn)展。
Abstract:
Objective:To evaluate the clinical efficacy of extracorporeal shock wave therapy(ESWT)in the treatment of early to mid-stage osteochondral lesions of the talus(OLT).Methods:Sixty eligible patients with Hepple I-Ⅲ OLT were enrolled and randomly divided into a control group(n=30)and an ESWT group(n=30).All patients were treated with conventional intervention therapies,such as acupuncture,ultrasound therapy,periankle strength training,oral administration of Diclofenac Sodium Enteric-coated Tablets,and protection from weight bearing of the affected limb.The patients in the ESWT group received additional ESWT.The treatment lasted five weeks for all patients.The ankle pain visual analogue scale scores,American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-Hindfoot Scale scores,and the volume of lesions of the two groups were compared before treatment and two months after treatment.Results:There was no significant difference in ankle pain VAS score,AOFAS Ankle-Hindfoot Scale score,and lesion volume between the two group before treatment(Z=0.139,P=0.709; Z=0.351,P=0.554; Z=0.184,P=0.668).Two months after treatment,ankle pain VAS scores of the two groups were lower((5,2)vs(5,2)points,Z=-2.828,P=0.005;(5,2)vs(3,1)points,Z=-4.902,P=0.000)and AOFAS Ankle-Hindfoot Scale scores were higher than those before treatment((69.50,11.75)vs(72.00,11.25)points,Z=-4.450,P=0.000;(68.50,11.50)vs(78.50,13.75)points,Z=-4.793,P=0.000).In the ESWT group,the lesion volume was reduced two months after treatment((1.77,0.76)vs(1.27,0.71)cm(3),Z=-4.783,P=0.000),and there was no significant difference in lesion volume of the control group before and after treatment((1.74,0.77)vs(1.79,0.54)cm(3),Z=-0.160,P=0.873).Compared with the control group two months after treatment,the ESWT group showed reduced ankle pain VAS score(Z=37.890,P=0.000),higher AOFAS Ankle-Hindfoot Scale score(Z=3.944,P=0.047),and smaller lesion volume(Z=15.134,P=0.000).Conclusion:In the treatment of early to mid-stage OLT,ESWT can relieve ankle pain,improve ankle function,and control lesion progression.

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(收稿日期:2022-08-14 本文編輯:李曉樂)

備注/Memo

備注/Memo:
基金項(xiàng)目:成都中醫(yī)藥大學(xué)科技發(fā)展基金項(xiàng)目(YYZX20180017)通訊作者:張鑫 E-mail:[email protected]
更新日期/Last Update: 1900-01-01