拮抗运动联合体外冲击波疗法对网球肘患者预后的影响

Effect of antagonistic exercise combined with extracorporeal shock wave therapy on prognosis of patients with tennis elbow

目的 探讨拮抗运动联合体外冲击波疗法对网球肘患者肘关节功能及炎症因子的影响。方法 将86例网球肘患者随机分为观察组和对照组,每组43例。对照组采用拮抗运动治疗,观察组采用拮抗运动联合体外冲击波疗法。2组均连续治疗8周,比较2组治疗效果。结果 治疗后8周,观察组前屈活动度、过伸活动度、内旋活动度、外旋活动度依次为(114.28±10.33)、(8.68±2.22)、(57.82±9.66)、(62.53±7.85)°,均大于对照组的(85.44±9.65)、(5.59±1.712)、(46.65±6.83)、(51.47±5.67)°,差异有统计学意义(P<0.05)。治疗后4、8周,观察组Mayo肘关节功能(MEPS)评分依次为(74.66±5.95)、(86.74±6.52)分,高于对照组的(67.51±4.78)、(80.32±5.33)分;观察组握力值依次为(23.63±3.59)、(25.86±3.77) kg,高于对照组的(19.18±2.74)、(23.42±2.22) kg,上述组间差异均有统计学意义(P<0.05)。治疗后8周,2组血清肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、白介素-1(IL-1)水平均较治疗前降低,但组间差异无统计学意义(P>0.05)。治疗后8周,观察组患侧肘关节伸肌总腱最大厚度为(3.24±0.11) mm,小于对照组的(4.62±0.42) mm,差异有统计学意义(P<0.05)。结论 拮抗运动联合体外冲击波疗法能够减轻网球肘患者的局部疼痛感和不适感,促进软组织愈合,改善肘关节活动度。

Objective To explore the effect of antagonistic exercise combined with extracorporeal shock wave therapy on elbow function and inflammatory factors in patients with tennis elbow.Methods A total of 86 patients with tennis elbow were randomly divided into observation group and control group,with 43 cases in each group.The control group was treated with antagonistic exercise,while the observation group was treated with antagonistic exercise combined with extracorporeal shock wave therapy.Both groups were treated for 8 weeks,and the therapeutic effect was compared between two groups.Results At 8 weeks after treatment,the degrees of flexion activity,excess extension activity,internal rotation activity and external rotation activity in the observation group were(114.28±10.33),(8.68±2.22),(57.82±9.66) and(62.53±7.85) °,which were significantly higher than( 85.44 ± 9.65),( 5.59 ± 1.712),( 46.65 ± 6.83) and( 51.47 ± 5.67) °in the control group( P 0.05).At 8 weeks after treatment,the maximum thickness of the extensor tendon of the elbow joint in the observation group was( 3.24 ± 0.11) mm,which was significantly smaller than( 4.62 ± 0.42) mm in the control group( P < 0.05).Conclusion Antagonistic exercise combined with extracorporeal shock wave therapy can alleviate the local pain and discomfort of patients with tennis elbow,promote healing of soft tissues,and improve elbow mobility.