高能震波治疗肌肉骨关节的慢性疼痛(英文)

High-energy shockwave for the chronic pain of muscle and bone joint

背景:目前有关用高能震波治疗肌肉骨关节慢性疼痛的报道不少,但其治疗的确切效果及作用机制不明确,有待进一步探讨。目的:探讨高能震波对骨关节肌筋膜炎的治疗效果、作用机制及临床应用效应。设计:以诊断为依据的非随机化同期对照研究。单位:中山大学附属第一医院康复医学科。对象:2001-07/2002-04中山大学第一附属医院康复科门诊救治的肌肉骨关节慢性疼痛患者90例,按就诊次序分为治疗组45例,男17例,女28例;平均年龄54岁;对照组45例,男15例,女30例,平均年龄63岁。方法:治疗组采用体外冲击波治疗;对照组采用常规物理因子治疗。用简式McGill疼痛问卷(MPQ)评估患者对疼痛的综合反应,并对肩关节活动范围及临床疗效进行评定。主要观察指标:①两组治疗前后疼痛改善程度。②关节活动度的变化。③综合临床疗效。结果:治疗组在治疗后感觉类,情感类,疼痛总分,目测类比定级(VAS),现有痛强度(PPI)方面与治疗前比较差异有显著性意义(t=5.69,5.67,7.06,8.37,6.21,P<0.01)。在感觉类,疼痛总分,VAS方面与对照组比较差异也有显著性意义(t=4.66,P<0.01;t=2.52,3.40,P<0.05)。结论:体外高能震波对骨关节肌筋膜炎等慢性疼痛疗效确切,临床应用上具有高效、快速、安全的特点。

BACKGROUND:At present,there are some reports regarding the treatment of high - energy shockwave to chronic pain of muscle and born joint,however,the therape utic effects and mechanism are still uncertain and need further discussion. OBJECTIVE:To explore the curative effects,mechanism and clinical application of high energy shockwave to bone joint myofascitis. DESIGN:Non- randomized case controlled study based on diagnosis SETTING:Rehabilitation Medicine Department of First Affiliated Hospital of Su n Yat- sen University. PARTICIPANTS:Totally 90 patients with chronic pain of muscle and bone joint t reated in Rehabilitation Medicine Department of First Affiliated Hospital of Sun Yat- sen University from July 2001 to April 2002 were divided into treatment g roup and control group each with 45 cases by the order of visiting time.There we re 17 males and 28 females in the treatment group with mean age of 54 years and 15 males and 30 females in the control group with mean age of 63 years. METHODS:Shockwave therapy was applied to the treatment group while routine ph ysical treatment was conducted to the control group. Simple McGill pain question naire(MPQ) was used to evaluate the general reactions of patients to pain and as sess the shoulder joint territory and clinical effects. MAIN OUTCOME MEASURES:① Improvement of pain before and after treatment in th e two groups.② Change of joint territory.③ General clinical therapeutic effec ts. RESULTS:There was significant difference on sensory,affective and pain score, visual analogous scale(VAS) and pain presentation inventory(PPI) before and afte r treatment in the treatment group(t=5.69,5.67,7.06,8.37,6.21,P< 0.01).When comp ared with control group,there was significant difference on sensory, pain score, VAS between the treatment group and control group(t=4.66,P< 0.01;t=2.52,3.40,P CONCLUSION:Extracorporeal high- energy shockwave has reliable effects on tre ating chronic pain caused by bone joint myofascitis, which is characterized by i ts effective, quick and safe features.