体外冲击波治疗网球肘的镇痛效果研究

The analgesia effect of extracorporeal shock wave therapy for tennis elbow

目的:探讨体外冲击波治疗网球肘的即刻镇痛效应及累积效应。方法:使用国产电磁式体外冲击波治疗机治疗45例网球肘患者,5日1次,共3次。分别在每次治疗前、治疗后、疗程结束后1周,采用现时疼痛状况(PPI)、视觉模拟量表(VAS)、Mills征评定进行疗效评价。结果:3次治疗后即刻均比治疗前疼痛程度显著降低,差异有显著性意义(P<0.001)。在治疗间歇期,疼痛较上次治疗后即刻增加,差异有显著性意义(P<0.001),但均比上次治疗前的疼痛程度低(P<0.001),疗程结束后疼痛程度显著减轻,由治疗前的(2.29±0.76)分降到治疗后的(0.74±0.52)分。治疗后VAS评分比上次评定均有显著改善,由治疗前的(5.06±1.51)分降到治疗后的(1.99±1.82)分。治疗前Mills征阳性率为95.6%,3次治疗后阳性率分别为86.7%、64.4%、33.3%,差异有显著性意义(P<0.001)。结论:体外冲击波治疗网球肘具有显著的即刻镇痛效果,多次治疗后的镇痛作用有累积效应。

Objective： To study the analgesia effect of extracorporeal shock wave therapy （ESWT） in tennis elbow. Method： Forty-five patients with persistent tennis elbow received 3 times ESWT with 5 days intervals. The analgesia effect was assessed by present pain intensity （PPI）, visual analogue scale （VAS） and Mills sign at the same day before and after treatment, and 1 week later of the last time treatment. Result： The analgesia effect after each treatment was obviously excellent than that before each treatment（P〈0.001）. At the intermission the pain increased, the PPI scores before next treatment were higher than that of former post-treatment （P〈0.001）, but were lower than that of former pre-treatment （P〈0.001）. At 1 week follow-up, the PPI scores and VAS scores decreased from （2.29±0.76） to （0.74±0.52） and （5.06±1.51） to （1.99±1.82） respectively, the positive rate of Mills sign decreased from 95.6% to 33.3%. Conclusion： ESWT has significantly immediate analgesia effect and accumulation effect of repeated treatment for tennis elbow.