发散式体外冲击波疗法治疗菱形肌损伤的疗效分析

Efficacy of radial extracorporeal shockwave therapy for treatment of rhomboid muscle injury

目的观察依据软组织外科学理论(soft tissue surgery theory)可否提升发散式体外冲击波疗法(radial extracorporeal shockwave therapy,rESWT)治疗菱形肌损伤(rhomboid muscle injury)的疗效。方法收集60例单侧菱形肌损伤患者的临床资料,根据治疗方式不同分成两组。实验组(n=30)依据软组织外科学理论行菱形肌走行区域联合患侧颈肩部(斜方肌、冈下三肌)rESWT,对照组(n=30)仅在菱形肌走行区域行rESWT,每周1次,共治疗4次。选用疼痛强度数字评价量表(numerical rating scale,NRS)评估和比较两组患者每次rESWT治疗前、完成4次rESWT治疗后随访4周、12周及24周共7个时间点的疼痛程度,并作疗效评价。结果两组患者后6个时间点的NRS评分均较第1个时间点和同组内前1个时间点显著降低(P<0.01)。治疗后同一时间点的比较,从第2周起,实验组NRS评分及显效率均优于对照组(P<0.05)。结论rESWT可缓解菱形肌损伤患者的疼痛,依据软组织外科学理论行菱形肌走行区域联合颈肩部rESWT治疗菱形肌损伤优于单一菱形肌走行区域rESWT。

Objective To investigate whether the soft tissue surgery theory can improve the efficacy of radial extracorporeal shockwave therapy(rESWT)in the treatment of rhomboid muscle injury.Methods Clinical data of 60 patients with unilateral rhomboid muscle injury was collected.The patients were divided into two groups depending on the different treatments.The experimental group(n=30)received rESWT in the rhomboid muscle area as well asthe affected side of the neck and shoulder muscles including trapezius muscle,infraspinatus muscle,major round muscle and minor round muscle according to the soft tissue surgery theory,and the control group(n=30)only received rESWT at the sensitive tenderness points in the rhomboid muscle area.The treatments were performed once aweek for a total of 4 times.The degree of pain in the two groups was evaluated and compared by numerical rating score(NRS)before each rESWT treatment and at 4 weeks,12 weeks and 24 weeks after 4 rESWT treatments,and the efficacy was evaluated.Results The NRS scores of patients in both groups at the last 6 time points were significantly lower than those at the 1 st time point and the prior time point in the same group(P<0.01).At the same time point after treatment,from the second week,the NRS score and efficacy in experimental group were better than those in control group(P<0.05).Conclusion rESWT can relieve pain in patients with rhomboid muscle injury.The rESWT in the rhomboid muscle area combined with neck and shoulder muscles according to the soft tissue surgery theory can produce better pain reduction compared with in rhomboid muscle area only.