体外冲击波联合肌内效贴治疗慢性非特异性腰痛的疗效观察

Effects of extracorporeal shock wave therapy combined with kinesio taping on chronic non-specific low back pain

目的观察体外冲击波联合肌内效贴治疗慢性非特异性腰痛(chronic non-specific low back pain,CNLBP)的临床效果。方法选取2021年1月—2022年1月在南通大学第二附属医院康复医学科就诊的CNLBP患者。采用随机数字表法将纳入患者分为冲击波组、肌内效贴组及联合治疗组。所有患者均接受常规康复治疗,冲击波组患者给予体外冲击波治疗,肌内效贴组患者给予肌内效贴治疗,联合治疗组患者予体外冲击波联合肌内效贴治疗。于治疗前、治疗4周后分别采用视觉模拟评分法(Visual Analogue Scale,VAS)、Oswestry功能障碍指数问卷(Oswestry Disability Index,ODI)、简明健康调查问卷(MOS 36-item Short form Health Survey,SF-36)以及焦虑自评量表(Self-rating Anxiety Scale,SAS)对3组患者的疼痛、腰椎功能障碍、生活质量及焦虑状态进行评估。结果共纳入患者85例。其中,冲击波组29例,肌内效贴组28例,联合治疗组28例;均未见不良反应。组内比较显示,3组在治疗4周后的VAS、ODI、SAS评分均低于治疗前(P<0.05),SF-36各维度评分则均高于治疗前(P<0.05)。治疗前,3组组间的VAS、ODI、SAS及SF-36各维度评分比较,差异均无统计学意义(P>0.05)。治疗4周后,3组组间的VAS、ODI、SAS及SF-36各维度评分比较,差异均有统计学意义(P<0.05)。组间多重比较显示,冲击波组、联合治疗组的VAS评分均低于肌内效贴组(P<0.05);联合治疗组的ODI评分分别低于冲击波组、肌内效贴组(P<0.05);联合治疗组的SAS评分低于肌内效贴组(P<0.05);3组间SF-36各维度评分两两比较,差异均有统计学意义(P<0.05);其他指标组间两两比较,差异均无统计学意义(P>0.05)。结论体外冲击波联合肌内效贴能够更为有效地改善CNLBP患者的疼痛和腰椎功能,提高患者的生存质量。

Objective To observe the effects of extracorporeal shock wave therapy(ESWT)combined with kinesio taping(KT)on chronic non-specific low back pain(CNLBP).Methods CNLBP patients who visited the Department of Rehabilitation Medicine,the Second Affiliated Hospital of Nantong University between January 2021 and January 2022 were selected.The included patients were divided into ESWT group,KT group,and combined treatment group using a random number table method.All patients received conventional rehabilitation.The ESWT group was treated with ESWT,the KT group was given KT therapy,and the combined treatment group were treated with ESWT and KT with the same treatment frequency as before.Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),MOS 36-item Short form Health Survey(SF-36)and Self-rating Anxiety Scale(SAS)were used to evaluate pain severity,lumbar spine function,quality of life,and anxiety status in all groups before and 4 weeks after treatment,respectively.Results A total of 85 patients were included.Among them,there were 29 cases in the ESWT group,28 cases in the KT group,and 28cases in the combined treatment group.There was no adverse event in any group.The intra-group comparison results showed that the VAS,ODI,and SAS scores of the three groups after 4 weeks of treatment were lower than those before treatment(P0.05),while the SF-36 scores in all dimensions were higher than those before treatment(P0.05).Before treatment,there was no statistically significant difference in VAS,ODI,SAS,or SF-36 scores among the three groups(P0.05).After 4 weeks of treatment,there were statistically significant differences in VAS,ODI,SAS,and SF-36 scores among the three groups(P0.05).The results of multiple comparisons between groups showed that the VAS scores of the ESWT group and the combination therapy group were lower than those of the KT group(P0.05);the ODI scores of the combination therapy group were lower than those of the ESWT group and the KT group(P0.05);the SAS scores of the combination therapy group were lower than those of the KT group(P0.05);the SF-36 scores of each dimension were compared in pairs among the three groups,and the differences were statistically significant(P0.05);there was no statistically significant difference in pairwise comparison of other indicators between groups(P0.05).Conclusion ESWT combined with KT can more effectively improve the pain and lumbar spine function of patients with CNLBP,and improve the quality of life of patients.