运用经络理论指导体外冲击波治疗跟腱炎临床研究

Clinical Study on Applying Meridian-collateral Theory in Instructing Extracorporeal Shock Wave for Achilles Tendonitis

目的:运用中医经络理论指导体外冲击波治疗跟腱炎,探讨中医经络理论对体外冲击波治疗方法的指导意义和临床价值。方法:经临床筛查将36例跟腱炎患者分为体外冲击波组及经络体外冲击波组,分别于治疗前、治疗后即刻、治疗后4个月以及治疗后12个月,对所有患者均采用VISA-A跟腱腱病评分表进行评分,对2组治疗前后的评分差值结果进行比较,在治疗后12个月时采用5点李克特量表对2组患者主观满意度进行评价。结果:治疗后,2组各时间点VISA-A评分分别与本组治疗前比较,差异均有统计学意义(P<0.01),表明体外冲击波治疗与经络体外冲击波治疗均能够改善跟腱炎临床症状。体外冲击波组治疗后各时间点与治疗前的VISA-A评分差值分别与经络体外冲击波组比较,差异均有统计学意义(P<0.05,P<0.01),表明经络体外冲击波组疗效优于体外冲击波组。治疗后12个月随访时5点李克特量表评分总满意率体外冲击波组77.8%,经络体外冲击波组88.9%。2组比较,差异有统计学意义(P<0.05)。结论:运用中医经络理论指导体外冲击波治疗跟腱炎效果优于常规体外冲击波治疗,存在一定的指导意义和临床价值,可在体外冲击波治疗其他疾病的应用上进一步深入探索。

Objective:To apply Chinese medicine meridian-collateral theory in instructing extracorporeal shock wave for achilles tendinitis, and discuss its instructive significance and clinical value. Methods: After clinical screening, divided 36 cases of patients with achilles tendonitis into the extracorporeal shock wave group and the meridian-collateral extracorporeal shock wave group. Before treatment,immediately after treatment,4 months and 12 months after treatment,assessed the scores of VISA-A scale;compared the difference values of scores in both groups before and after treatment,and evaluated the degree of subjective satisfaction of patients in both groups via 5-point Likert scale 12 months after treatment. Results:After treatment,comparing the scores of VISA-A in both groups in each time point with those before treatment,there were significant differences being found(P<0.01),indicating that the treatment with both extracorporeal shock wave and meridiancollateral extracorporeal shock wave could improve the clinical symptoms of achilles tendinitis. After treatment, comparing the difference values of VISA-A scores in the extracorporeal shock wave group in each time point with those in the meridiancollateral extracorporeal shock group,there were significant differences being found(P<0.05,P<0.01),indicating that the meridian-collateral extracorporeal shock wave group had better therapeutic effect than the extracorporeal shock wave group.12 months after treatment during follow-ups, the total satisfaction rate in 5-point Likert scale was 77.8% in the extracorporeal shock wave group and 88.9% in the meridian-collateral extracorporeal shock group, difference being significant(P<0.05). Conclusion:The application of Chinese medicine meridian-collateral theory in instructing extracorporeal shock wave for achilles tendinitis has better therapeutic effect than routine treatment with extracorporeal shock wave,which shows certain instructive significance and clinical value. There remain further explorations into the application of extracorporeal shock wave in treating other diseases.