体外冲击波治疗肩周炎治疗次数与镇痛效果的关系研究

The Relationship between Analgesic Effect and Treatment Frequency of Extracorporeal Shock Wave Therapy for Scapulohumeral Periarthritis

目的:探讨体外冲击波治疗肩周炎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71例肩周炎患者,5天1次,共3次,所有患者试验前接受为期2周的临床洗脱期。分别在每次治疗前、治疗后、疗程结束后1周,进行PPI、VAS、ROM、ADL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(P<0.001)。在治疗间歇期,PPI疼痛评分较上次治疗后即刻增加(P<0.001),但均比上次治疗前的疼痛程度低(P<0.001),疗程结束1周后随访疼痛程度显著减轻,由治疗前的(2.41±0.67)分降到治疗后的(1.23±0.78)分。治疗后VAS、ROM、ADL评分比上次评定均有显著改善,VAS由治疗前的(5.49±1.49)分降到治疗后的(2.79±1.95)分,ROM由治疗前的(3.69±2.18)分降到治疗后的(1.54±1.77)分,ADL由治疗前的(4.94±2.61)分降到治疗后的(1.96±2.30)分。结论:体外冲击波治疗肩周炎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 relationship between analgesic effect and treatment frequency of extracorporeal shock wave therapy （ESWT）for scapulohumeral periarthritis. Methods 71 patients with scapulohumeral periarthritis received 3 times ESWT with an interval of 5 days. The analgesic effect was assessed by present pain intensity （PPI）,visual analogue scale （VAS）, range of motion （ROM）and daily activity level （ADL）at the same day before and after treatment,and 1 week after the last treatment. Results The analgesic effect after each treatment appeared obviously （P 〈 0.001 ）. The pain occurred atthe intermission,but the PPI scores before next treatment were higher than last post-treatment （P〈 0.001） ,but lower than last pre-treatment （P 〈 0.001 ）. The PPI scores and VAS scores decreased from 2.41±0.67 to 1.23±0.78 and 5.49±1.49 to 2.79±1 .95 , respectively , and the ROM and ADL improved significantly 1 week after the final ESWT. Conclusion Extracorporeal shock wave therapy for seapulohumeral periarthritis showed immediate analgesic effect,and the effect could be accumulatedafter repeated treatment.