体外冲击波治疗足底筋膜炎疗效研究

Effect of extracorporeal shock wave therapy on plantar fasciitis

目的探讨体外冲击波在足底筋膜炎中应用价值。方法选择2017年1月至2018年10月荆门市第二人民医院足底筋膜炎患者60例,其中男性26例,女性34例;年龄30~59岁,平均年龄44.51岁;体质量50.8~74.4 kg,平均体质量62.63 kg;病程3.3~27.3个月,平均病程15.29个月;疼痛程度视觉模拟量表(VAS)评分6~8分,平均评分7.01分。随机数字表法分为对照组(n=30)与研究组(n=30)。对照组采取常规治疗,研究组于对照组基础上采取体外冲击波疗法,共治疗10 d。统计两组治疗前及治疗5 d后、治疗10 d后疼痛程度(VAS)、足踝功能(AOFAS)、足底筋膜厚度、最长持续行走时间、临床疗效。结果疼痛程度:治疗5 d后、治疗10 d后,两组VAS评分值较治疗前降低,且研究组[(3.23±0.38)分、(2.81±0.36)分]低于对照组(P <0.05)。临床疗效:研究组总有效率(96.67%)高于对照组(73.33%)(P <0.05)。足踝功能:治疗5 d后、治疗10 d后两组AOFAS分值较治疗前增高,且研究组[(77.06±6.15)分、(89.02±4.33)分]高于对照组(P <0.05)。足底筋膜厚度:治疗5 d后、治疗10 d后两组足底筋膜厚度较治疗前减小,且研究组[(4.36±0.50) mm、(3.89±0.38) mm]小于对照组(P <0.05)。最长持续行走时间:治疗5 d后、治疗10 d后两组最长持续行走时间较治疗前延长,且研究组[(74.04±13.34) min、(106.56±21.22) min]长于对照组(P <0.05)。结论采取体外冲击波治疗足底筋膜炎,可有效减轻患者疼痛程度,减小足底筋膜厚度,改善患者足踝功能,且可延长其最长持续行走时间,利于提升疾病整体治疗效果。

Objective To explore the application value of extracorporeal shock wave in plantar fasciitis. Methods From January 2017 to October 2018, a total of 60 patients with plantar fasciitis were enrolled, which included 26 males and 34 females;aged 30-59 years old with mean age of 44.51 years old;body mass was 50.8-74.4 kg with mean body mass of 62.63 kg;disease duration was 3.3-27.3 months with mean disease duration of 15.29 months;pain level visual analogue scale(VAS)was 6-8 scores with mean score of 7.01 scores. All of them were divided into control group(n = 30) and study group(n = 30) by random number table method. The control group received routine treatment for 10 days and study group received extracorpore-al shock wave therapy based on control group. The VAS, American Orthopaedic Foot and Ankle Association(AOFAS), thickness of plantar fascia, maximum continuous walking time, and clinical efficacy were compared before treatment, 5-day after treatment and 10-day after treatment between 2 groups. Results For pain level 5-day and 10-day after treatment, the VAS scores of 2 groups were lower than those of before treatment, and study group[(3.23 ± 0.38) scores,(2.81 ± 0.36) scores] was lower than those of control group(P < 0.05). For clinical efficacy, total effective rate of study group(96.67 %) was significantly higher than that of control group(73.33 %)(P < 0.05). For foot and ankle function, after treating for 5-day and 10-day, the AOFAS scores of 2 groups were higher than those of before treatment, and study group[(77.06 ± 6.15) scores,(89.02 ± 4.33) scores]were significantly higher than those of control group(P < 0.05). For plantar fascia thickness, 5-day and 10-day after treatment of 2 groups were decreased than that of before treatment, and study group[(4.36 ± 0.50) mm,(3.89 ± 0.38) mm]was significantly smaller than that of control group(P < 0.05). After treatment 5-day and 10-day continuous walking time of 2 groups were longer than those of before treatment, and study group[(74.04 ± 13.34) minutes,(106.56 ± 21.22) minutes] were significantly longer than those of control group(P < 0.05). Conclusion It is demonstrated that extracorporeal shock wave therapy could effectively relieve pain level, reduce thickness of plantar fascia, improve ankle function, and prolong the maximum continuous walking time in treatment of plantar fasciitis, which is conducive to improve the overall therapeutic effect.