体外冲击波与关节松动术治疗肩关节周围炎的临床疗效对比

A controlled clinical study of the effectiveness of extracorporeal shock wave therapy and joint mobilization technique in the treatment of periarthritis of shoulder

目的 比较体外冲击波与关节松动术在治疗肩关节周同炎方面的疗效差异，从而为体外冲击波在临床中更广泛的应用提供依据。方法 共选取82例肩关节周围炎患者，将其随机分为治疗组（采用体外冲击波治疗，n=42）与对照组（采用关节松动术治疗，n=40）。体外冲击波频率为60次／min，强度为0．18～0.25ml／mm^2，每次治疗时共冲击1000次，每5天治疗1次，共治疗3次。关节松动术治疗每天1次，每次持续30～40min，共治疗15次。采用视觉模拟评分法（VAS）评定患者治疗前、后的痛觉变化；选用Constant-Murley肩功能评分法（C-M评分）评定患者治疗前、后ADL及ROM的改变情况。结果 2组患者经相应治疗后其疼痛及C-M评分均较治疗前明显改善。差异有统计学意义（P〈0.01），治疗后2组患者上述评分进行比较，差异亦有统计学意义（P〈0．05），且治疗组患者疗效明显优于对照组，差异有统计学意义（P〈0．05）。结论 体外冲击波治疗肩关节周围炎的疗效明显优于关节松动术，值得临床进一步推广、应用。

Objective To observe and compare the effects of extracorporeal shock wave therapy （ESWT） and that of joint mobilization technique on periarthritis of shoulder. Methods Eighty-two patients were divided into two groups randomly, a treatment group （ n = 42） treated with extracorporeal shock wave therapy, and a control group （n = 40） treated with joint mobilization technique. All the patients were evaluated with Visual Analogue Scale （VAS） and Constant-Murley Scale（C-M scale） before and half a month after the treatment, Results After treatment the results obtained with the use of VAS Scale and C-M Scale （ only ADL and ROM） were significantly different in two groups when compared with those before the treatment （ P 〈 0.01 ） ,the treatment group was significantly different from the control group after treatment （ P 〈 0.05 ） ,the clinical effects of the treatment group was superior to that of the control group （P 〈 0.05 ）. Conclusion Extracorporeal shock wave therapy is more effective for periarthritis of shoulder than joint mobilization technique.