体外冲击波治疗慢性非特异性腰痛的疗效观察

Effect of extracorporeal shock wave therapy on chronic low back pain

目的观察体外冲击波治疗慢性非特异性腰痛的临床疗效。方法将2018年12月-2019年7月在解放军总医院第一医学中心康复医学科门诊诊断为慢性非特异性腰痛的80例患者分为试验组40例及对照组40例。对照组给予常规康复理疗(如电刺激、热疗、超声波治疗等),每天1次,连续2周;试验组给予体外冲击波治疗(治疗压力为2~2.5 bar,频率8 Hz,冲击2000次),隔天1次,共5次。于治疗前、治疗2周后进行疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数问卷表(Oswestry Disability Index,ODI)评价,并进行组间比较。结果试验组4例脱落。治疗前两组VAS评分差异无统计学意义(P>0.05),但ODI评分实验组显著劣于对照组(P<0.05)。治疗2周后两组患者VAS评分及ODI评分均较治疗前明显改善(P均<0.05),且试验组VAS评分及ODI评分显著优于对照组(P均<0.05)。结论低能量、短疗程的冲击波治疗可减轻慢性非特异性腰痛患者疼痛症状,改善腰部功能障碍。

Objective To evaluate the effect of extracorporeal shockwave therapy(ESWT)in treatment of chronic low back pain.Methods From December 2018 to July 2019,80 patients with chronic low back pain(CLBP)admitted to the department of rehabilitation medicine in the First Medical Center of Chinese PLA General Hospital were randomly assigned into ESWT group(n=40)and control group(n=40).The patients of the ESWT group received ESWT(2000 pulses with the pressure of 2-2.5bars,energy flux density of 0.1 mJ/mm^2,8Hz frequency),every other day,five treatments in total;and the control group(n=40)received frequently-used physical treatment(ultrasonic wave treatment,magnet therapy,electric stimulation et al),once a day,two weeks in total.The patients were assessed by using Visual Analogue Scale(VAS),Oswestry Disability Index(ODI).The data were obtained before treatment,and after two-week treatment.Results Four cases in the ESWT group dropped out.Before treatment,the ESWT group had similar VAS(P>0.05),but worsen ODI when compared to the control group.After treatment,the VAS score and ODI score of both groups decreased significantly compared with baseline(P<0.05,respectively),and the scores of VAS,ODI in the ESWT group were better than those in the control group(P<0.05,respectively).Conclusion Short-term ESWT with low energy flux density is effective and safe in treatment of chronic low back pain,which can reduce the pain and improve the general functional state.