体外冲击波治疗肱骨外上髁炎的效果评价:一项短-中期随访

Effect of extracorporeal shock wave on epicondylitis of humerus:a short⁃to⁃mid⁃term follow⁃up

目的通过短⁃中期随访观察体外冲击波(extracorporeal shock waves,ESW)治疗肱骨外上髁炎(lateral epicondylitis,LE)的临床疗效。方法将符合要求的104例LE患者随机分为两组,50例患者采用ESW治疗(ESW组),54例患者采用局部封闭治疗(传统治疗组)。两组患者每周治疗1次,4周为1个疗程,共治疗1个疗程。分别于治疗前、治疗结束时、治疗结束后4、24、48周,比较两组患者休息、握拳时肘部疼痛视觉模拟量表(visual analogue scale,VAS)评分、治疗复发率及满意度。结果两组患者治疗结束时、治疗结束4周在休息及握拳时肘部疼痛VAS评分比较差异无统计学意义(P>0.05);在治疗结束后24、48周,ESW组在休息及握拳时VAS评分较传统治疗组低,差异有统计学意义(P<0.05)。ESW组患者经过短-中期随访,复发率及满意度分别为8.00%及76.0%,而传统治疗组则为29.63%及55.56%,两组患者比较差异有统计学意义(P<0.05)。结论采用ESW和局部封闭治疗均能有效治疗LE,短-中期随访显示,ESW对LE的有效持续时间更长、复发率更低、满意度更高。

Objective To observe the clinical efficacy of extracorporeal shock wave(ESW)in treating epicondylitis of humerus through short⁃to⁃medium follow⁃up.Methods A total of 104 patients with epicondylitis humerus were randomly divided into ESW group(n=50),and traditional treatment group(n=54)for one course of treatment(once a week,4 weeks as a course of treatment).The visual analogue scale(VAS)score,recurrence rate,and patient satisfaction of the two groups were compared before,at the end of,and 4,24 and 48 weeks after the treatment.Results There was no significant difference in terms of VAS score when at rest and making fist between the two groups at the end of and 4 weeks after the treatment(P>0.05)but at the end of,24 and 48 weeks after the treatment,the ESW group had lower VAS score when at rest and making fist and difference was statistically significant(P<0.05).Short⁃to⁃medium follow⁃up showed recurrence rate and satisfaction rate in ESW group was 8.00%and 76.0%,respectively,and that was 29.63%and 55.56%in the traditional treatment group,indicating statistical significance(P<0.05).Conclusion Both ESW and local closure therapy are effective for epicondylitis of the humerus.Short⁃to⁃mid⁃term follow⁃up shows that ESW has a longer duration,lower recurrence rate,and higher patient satisfaction.