体外冲击波疗法在骨组织及肌肉系统疾病中的应用

Extracorporeal shock wave therapy for musculoskeletal system diseases

目的:体外冲击波疗法作为骨科领域一种新兴的物理治疗方法,现已被广泛关注。探寻体外冲击波的产生机制、特性、分类及各自特点,体外冲击波疗法的产生、发展演变、应用现状,重要进展,以及其治疗机制和前景展望。资料来源:应用计算机检索NCBIEntrezPubMed1990-01/2004-04相关体外冲击波疗法的文章,检索词为“ExtracorporealShockWave”,限定文章语言种类为英语;计算机检索CNKI1994-01/2004-04相关体外冲击波疗法的文章。资料选择:对资料进行初审,纳入标准:①有关体外冲击波的产生机制、分类、物理特性研究。②有关体外冲击波疗法在骨组织及肌肉系统等疾病的基础及临床研究。排除标准:文献中重复研究、综述、Mata分析类文章。未排除文章中资料是否应用了随机、对照和盲法。资料提炼:共收集到51篇相关文献,含追溯法查找文献5篇,33篇符合纳入标准,排除18篇文献,其中5篇系重复研究,7篇为体外冲击波在泌尿系统的应用,6篇为体外冲击波机器的故障的检查与维修。资料综合:33篇文献中21篇通过临床研究或动物实验,以对照研究方法证实体外冲击波疗法治疗慢性软组织损伤、骨不连,骨延迟愈合疗效明显,差异显著,并发症少,并探讨具体治疗方法、疗效评价、副作用、适应证、禁忌证以及作用机制;

OBJECTIVE:Extracorporeal shock wave therapy(ESWT),a newly rising method of phy siotherapy,has been paid much attention to.The aim of this study is to investiga te the developing mechanism,properties,classification and characteristics of ext racorporeal shock wave(ESW),study the development,variation,application status a nd essential progress of ESWT,and probe into its therapeutic mechanism and prosp ect. DATA SOURCES:The relevant articles to ESWT from January 1999 to April 2004 wer e searched for in NCBI Entrez PubMed by inputting the key word“Extracorporeal Shock Wave' in English into a computer.Similarly,the relevant articles to ESWT i n Chinese from January 1994 to April 2004 were searched for in China National Kn owledge Infrastructure(CNKI). STUDY SELECTION:Having been looked through primarily,the included articles wer e ①the study on developing mechanism,classification and physical properties of ESW,and ②the basis and clinical study on the ESWT for musculoskeletal system di seases;The excluded articles were those about repetitive study,review and Mata a nalysis.Whether the articles adopted random,control and blind methods were not e xcluded. DATA EXTRACTION:A total of 51 relevant literatures were collected,including 5 literatures by means of tracing back,33 included articles and 18 excluded articl es(5 for repetitive study,7 for the application of ESW in urinary system and 6 f or check up and repair of ESW machine malfunction). DATA SYNTHESIS:Of the 33 articles,21 were about the obvious effect of ESWT in treating chronic soft tissue injury,nonunion and delayed union of bone with litt le complication confirmed by means of controlled method through clinical study a nd animal experiment,and also about the detailed therapy,evaluation of curative effect,side effects,adaptive symptoms,contraindication and action mechanism;3 we re about ESWT for aseptic necrosis of femoral head and regressive lesion in midd le and elder people,and investigation of action mechanism of ESWT;4 were about r elationship among effective energy flow density,frequency and curative effect of ESWT;and 1 was about effect of ESWT on periosteal tissues. CONCLUSION:Based on extracorporeal shock wave lithotripsy(ESWL),the ESWT for m usculoskeletal system diseases was more in the basic and clinical study,mature i n therapeutic methods,enlarged in treatment field,satisfied in therapeutic effec ts,and better than conventional therapy.It is believed that ESWT will be indispe nsable in treating musculoskeletal system diseases with extensive prospect.