体外冲击波联合离心肌力训练治疗肱骨外上髁炎的疗效观察

Clinical Study of Extracorporeal Shock Wave Therapy Combined with Eccentric Strength Training in Treatment of Lateral Epicondylitis

目的:观察体外冲击波(ESWT)联合离心肌力训练(EST)治疗肱骨外上髁炎(LE)的临床疗效。方法:选取2019年1月~2019年12月在江苏省苏北人民医院骨科及康复科治疗例肱骨外上髁炎患者56例,采用随机数字表法将其分为观察组和对照组各28例。两组患者均给予离心肌力训练,观察组在此基础上辅以体外冲击波治疗。治疗前、治疗4周、治疗后8周及12周分别采用视觉模拟评分(VAS)、握力测试及病患网球肘评价(PRTEE)对两组患者进行评定,并记录不良事件。结果:治疗前,两组患者VAS评分、握力、PRTEE评分间比较,差异均无统计学意义(P>0.05);治疗结束后,两组患者VAS、握力、PRTEE评分较组内治疗前均显著改善,差异均有统计学意义(P<0.05);观察组患者治疗后不同时间点VAS、握力值、PRTEE评分改善均优于对照组,差异均有统计学意义(P<0.05);对照组患者治疗后12周时,其疼痛VAS评分较治疗4周及治疗后8周时有轻度上升,而观察组VAS评分则相对稳定;对照组PRTEE评分治疗后12周与治疗后8周相比,差异无统计学意义(P>0.05)。结论:体外冲击波联合离心肌力训练可显著缓解肱骨外上髁炎患者的疼痛,增加握力并改善肘关节功能,该联合疗法值得临床进一步推广应用。

Objective:To objective the clinical efficacy of extracorporeal shock wave therapy(ESWT) combined with eccentric strength training(EST) for the treatment of lateral epicondylitis(LE).Methods:A total of 56 patients with external humeral epicondylitis treated in the Department of Orthopedics and Rehabilitation of Subei People’s Hospital in Jiangsu Province from January to December 2019 were selected and divided into the observation group and the control group with 28 cases in each group by random number table method.Both groups were given centrifugal muscle strength training,and the observation group was supplemented with extracorpical shock wave therapy on the basis of this.Visual analogue scale(VAS),grip strength test and patient tennis Elbow evaluation(PRTEE) were used to evaluate patients before treatment,4 weeks after treatment,8 weeks after treatment and 12 weeks after treatment,respectively.Results:Before treatment,there were no statistical significance in VAS score,grip strength and PRTEE score between 2 groups(P>0.05).After treatment,VAS,grip strength and PRTEE scores of 2 groups were significantly improved compared with those before treatment,and the differences were statistically significant(P<0.05).VAS,grip strength and PRTEE scores in observation group were better than those in control group at different time points after treatment,and the differences were statistically significant(P<0.05).At 12 weeks after treatment,the VAS score of the control group was slightly increased compared with 4 weeks and 8 weeks after treatment,while the VAS score of the observation group was relatively stable.There was no statistical significance in PRTEE score of the control group at 12 weeks after treatment compared with 8 weeks after treatment(P>0.05).Conclusion:Extracorporeal shock wave therapy combined with eccentric strength training can significantly relieve the pain of patients with lateral epicondylitis,increase grip strength and improve the function of elbow joint.This combination therapy is worthy of further clinical promotion and application.