体外冲击波联合深层摩擦按摩治疗肱骨外上髁炎的临床研究

Clinical Study of Extracorporeal Shock Wave Therapy Combined with Deep Friction Massage in the Treatment of Lateral Epicondylitis

目的:探讨体外冲击波(ESWT)联合深层摩擦按摩(DFM)治疗肱骨外上髁炎(LE)的临床疗效。方法:选择2017年4月~2018年12月在江苏省苏北人民医院收治的LE患者66例,按照随机数字表法将其分为A、B、C共三组,每组22例。A组患者给予体外冲击波治疗联合深层摩擦按摩手法;B组患者接受单纯体外冲击波治疗;C组患者接受单纯深层摩擦按摩手法治疗。三组患者均于治疗前、疗程结束时、治疗后8周、12周采用视觉模拟评分(VAS)、Mayo肘关节功能评分系统(MEPS)来评估患者肘关节疼痛程度和肘关节功能改善情况,并进行综合疗效评价,记录不良事件。结果:三组患者治疗前VAS、MEPS评分比较,差异无统计学意义(P>0.05);治疗结束后,三组患者不同时间点的VAS、MEPS评分均优于治疗前,差异均有统计学意义(P<0.05);A组患者治疗后不同时间点VAS、MEPS评分改善均优于B组和C组,差异均有统计学意义(P<0.05);治疗后12周,A组患者的总有效率为95.24%,显著优于B组的71.43%和C组的75.00%,差异均有统计学意义(P<0.05)。结论:体外冲击波联合深层摩擦按摩手法能更好的缓解肱骨外上髁炎患者的疼痛,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 deep friction massage(DFM)for the treatment of lateral epicondylitis(LE).Methods:A total of 66 patients with LE treated in Jiangsu Northern People’s Hospital from April 2017 to December 2018 were randomly divided into three groups:group A(treated with extracorporeal shock wave therapy plus deep friction massage),group B(treated with extracorporeal shock wave therapy),and group C(treated with deep friction massage merely),and each had 22 patients.Before treatment,at the end of the course of treatment,8 weeks and 12 weeks after treatment,the visual analog scale(VAS)and Mayo elbow function score system(MEPS)were used to evaluate the degree of elbow pain and the improvement of elbow function,and the comprehensive curative effect was evaluated,and the adverse events were recorded.Results:There was no significant difference in VAS and MEPs scores among the three groups before treatment(P>0.05);After treatment,the vas and MEPs scores of the three groups at different time points were better than those before treatment(P<0.05);The scores of vas and MEPs in group A were better than those in group B and group C at different time points after treatment(P<0.05);12 weeks after treatment,the total effective rate of group A was 95.24%,which was significantly better than 71.43%in group B and 75.00%in group C(P<0.05).Conclusion:The clinical effect of extracorporeal shock wave combined with deep friction massage in the treatment of LE is significantly better than that of extracorporeal shock wave alone.This combination therapy is worthy of further clinical promotion and application.