基于筋膜线理论的冲击波治疗肱骨外上髁炎临床研究

Treatment of external humeral epicondylitis with shock wave based on myofascial lines theory

目的:以筋膜线理论为依据,本着解剖与功能的整体观,探讨冲击波法治疗肱骨外上髁炎的疗效。方法:将80例肱骨外上髁炎患者随机分为对照组和观察组,每组40例,对照组采用传统的方法(肱骨外上髁局部)进行冲击波治疗,观察组采用肌筋膜经线理论(沿臂表浅线)进行冲击波治疗。每3天1次治疗,共治疗5次。分别于治疗前、治疗后1周、1、3、6个月对2组进行视觉模拟评分(VAS)、上肢功能评分(DASH)及肱骨外上髁压痛阈值(PPT)评价。结果:治疗后1周、1、3、6个月,2组在VAS及DASH评分均较治疗前明显降低(均P<0.05),观察组在治疗后各时间点VAS及DASH评分均更低于对照组(均P<0.05)。2组在治疗后1周PPT与治疗前无明显变化,在治疗后1、3、6个月PPT明显提高(均P<0.05),尤以观察组提高更显著(P<0.05)。对照组在治疗后6个月时VAS、DASH评分及PPT较前轻度反弹,而观察组相对稳定。结论:以肌筋膜经线理论为依据,沿臂表浅线进行冲击波治疗的效果优于单纯肱骨外上髁局部治疗。

Objective： Based on the theory of myofascial lines, to study the treatment of external humeral epicondy litis in the view of anatomy and function by shockwave method. Methods： Eighty patients with external humeral epi condylitis were randomly divided into control group and treatment group （n=40 each group）. Patients in the control group were treated with traditional shock wave therapy at the lateral epicondylar region of the humerus, and those in the treatment group were given shock wave along the superficial line of the arm based on myofascial meridian theory. Patients were treated once every 3 days, 5 times totally. The visual analogue scale （VAS）, disability of arm shoul der and hand （DASH） and pain threshold （PPT） were measured before and at 1st week, 1st month, 3rd month and 6th month after treatment. Results： After the treatment for one week, one month, three months and six months, the VAS and DASH scores in both groups were significantly reduced after treatment （all P〈0.05）. The VAS and DASH scores in treatment group were significantly lower than those in control group at every time point after treat ment （all P〈0.05）. There was no significant change in two groups before and at 1st week after treatment. PPT in two groups was significantly improved in the first month, third month and sixth month after treatment （P〈0.05） , especially in treatment group. VAS, DASH scores, and PPT rebounded slightly in the sixth month after treatment in control group, while they were relatively stable in treatment group. Conclusions： It is better to treat with shock wave along the superficial line of the arm than that at the lateral epicondylar region of the humerus based on myofas cial lines theory.