体外冲击波联合腕踝针治疗肱二头肌长头肌腱炎的临床研究

A clinical study of extracorporeal shockwave therapy combined with wrist-ankle acupuncture therapy for treatment of myotenositis of long head of biceps brachii

目的:观察体外冲击波联合腕踝针治疗肱二头肌长头肌腱炎的临床疗效。方法:将80例肱二头肌长头肌腱炎患者随机分为2组,每组40例。联合组采用体外冲击波联合腕踝针治疗,封闭组采用局部封闭治疗。体外冲击波治疗每周1次,连续治疗3次;腕踝针治疗隔天1次,连续治疗3周;局部封闭治疗每周1次,共治疗3次。分别于治疗前和治疗结束后比较患者的肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、Constant-Murley肩关节评分,并于治疗结束后按照自拟标准评价总体疗效。结果:联合组1例患者因未能坚持完成治疗而被剔除。治疗前2组患者的肩关节疼痛VAS评分比较,差异无统计学意义(t=0. 535,P=0. 594);治疗结束后2组患者的VAS评分均较治疗前降低[联合组:(7. 10±1. 05)分,(2. 64±1. 18)分,t=17. 377,P=0. 000;封闭组:(6. 98±1. 07)分,(3. 23±0. 89)分,t=19. 533,P=0. 000],联合组的VAS评分低于封闭组(t=-2. 485,P=0. 015)。治疗前2组患者的Constant-Murley评分比较,差异无统计学意义(t=-1. 367,P=0. 176);治疗结束后2组患者的Constant-Murley评分均较治疗前升高[联合组:(29. 41±6. 15)分,(77. 10±7. 41)分,t=-33. 733,P=0. 000;封闭组:(31. 38±6. 60)分,(70. 95±6. 07)分,t=-30. 574,P=0. 000],联合组的Constant-Murley评分高于封闭组(t=4. 041,P=0. 000)。联合组的总体疗效优于封闭组(R_(联合组)=35. 03,R_(封闭组)=44. 85,Z=-2. 036,P=0. 042)。结论:体外冲击波联合腕踝针可以有效减轻肱二头肌长头肌腱炎患者的疼痛,改善肩关节功能,总体疗效优于局部封闭治疗。

Objective:To observe the clinical curative effects of extracorporeal shockwave(ESW)therapy combined with wrist-ankle acupuncture therapy for treatment of myotenositis of long head of biceps brachii.Methods:Eighty patients with myotenositis of long head of biceps brachii were randomly divided into combination therapy group and blocking group,40 cases in each group.The patients in combination therapy group were treated with ESW therapy combined with wrist-ankle acupuncture therapy,while the patients in blocking group were treated with local blocking therapy.The ESW therapy was performed once a week for consecutive 3 times.The wrist-ankle acupuncture therapy was performed on alternate days for consecutive 3 weeks.The local blocking therapy was performed once a week for totally 3 times.The shoulder pain visual analogue scale(VAS)scores and Constant-Murley shoulder scores were evaluated before treatment and after the end of the treatment respectively,and the total curative effects were evaluated according to the self-made evaluation standards after the end of the treatment.Results:One patient in combination therapy group was excluded for failing to finish the treatment.There was no statistical difference in shoulder pain VAS scores between the 2 groups before the treatment(t=0.535,P=0.594).The shoulder pain VAS scores decreased in both of the 2 groups after the end of the treatment compared to pre-treatment(combination therapy group:7.10+/-1.05 vs 2.64+/-1.18 points,t=17.377,P=0.000;blocking group:6.98+/-1.07 vs 3.23+/-0.89 points,t=19.533,P=0.000],and the VAS scores were lower in combination therapy group compared to blocking group(t=-2.485,P=0.015).There was no statistical difference in Constant-Murley scores between the 2 groups before the treatment(t=-1.367,P=0.176).The Constant-Murley scores increased in both of the 2 groups after the end of the treatment compared to pre-treatment(combination therapy group:29.41+/-6.15 vs77.10+/-7.41 points,t=-33.733,P=0.000;blocking group:31.38+/-6.60 vs 70.95+/-6.07 points,t=-30.574,P=0.000),and the Constant-Murley scores were higher in combination therapy group compared to blocking group(t=4.041,P=0.000).The combination therapy group surpassed the blocking group in the total curative effect(Rcombination therapy group=35.03,Rblocking group=44.85,Z=-2.036,P=0.042).Conclusion:The combination therapy of ESW and wrist-ankle acupuncture can effectively alleviate pain and improve shoulder function in patients with myotenositis of long head of biceps brachii,and its total curative effect is better than that of local blocking therapy.