神经松动术联合体外冲击波治疗梨状肌综合征的疗效分析

The Efficacy of Combining Nerve Mobilization with Extracorporeal Shock Wave Therapy for the Treatment of Piriformis Syndrome

目的观察神经松动术联合体外冲击波治疗梨状肌综合征的临床疗效。方法收集2022年8月至2023年7月就诊于厦门大学附属中山医院的梨状肌综合征患者共160例,以随机数字表法分为常规康复组、冲击波组、神经松动术组及联合治疗组,每组40例。常规康复组予以常规治疗,冲击波组及神经松动术组分别在前者基础上给予冲击波及神经松动术治疗,联合治疗组则在该基础上采用神经松动术和体外冲击波联合治疗,共治疗4周。以临床疗效评定、疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及日本骨科协会评估治疗分数(JOA)为结局指标。结果常规康复组治疗后的总有效率为85.00%,神经松动组、冲击波组及联合治疗组的有效率分别为95.00%、80.00%及97.50%,联合治疗组有效率最高,且4组患者治疗后的临床有效率差异有统计学意义(P<0.05)。4组治疗后的VAS及ODI评分均较前下降,联合治疗组VAS及ODI评分下降最为显著(均P<0.05)。4组治疗后的JOA评分均较前升高,联合治疗组JOA评分最高(P<0.05)。结论神经松动术联合冲击波治疗可有效改善梨状肌综合征临床症状,减轻疼痛。

Objective Observation on the clinical efficacy of nerve relaxation combined with extracorporeal shock wave in the treatment of pyriformis syndrome.Methods A total of 160 patients with pyriformis syndrome who attended Zhongshan Hospital of Xiamen University from August 2022 to July 2023 were collected and divided into conventional rehabilitation group,shockwave group,nerve relaxation group and combined treatment group by random number table method,with 40 cases in each group.The conventional rehabilitation group was treated routinely,the shockwave group and the nerve relaxation group were treated with shockwave and nerve relaxation on the basis of the former,and the combined treatment group was treated with nerve relaxation and extracorporeal shockwave on the basis of the former,and a total of 4 weeks of treatment was given.Clinical outcome assessment,visual analogue score(VAS)of pain,Oswestry dysfunction index(ODI)and Japanese Orthopaedic Association Assessment Treatment Score(JOA)were used as outcome indicators.Results The total effective rate after treatment was 85.00%in the conventional rehabilitation group,95.00%,80.00%and 97.50%in the nerve relaxation group,shockwave group and combined treatment group,respectively,and the combined treatment group had the highest effective rate,and the difference in clinical effective rate among the 4 groups was statistically significant(P<0.05).VAS and ODI scores of the 4 groups decreased compared with the previous ones,and VAS and ODI scores decreased most significantly in the combined treatment group(both P<0.05).JOA scores increased in all 4 groups,and JOA scores were the highest in the combined treatment group(P<0.05).Conclusions Nerve release combined with shockwave therapy is effective in improving clinical symptoms and reducing pain in pyriformis syndrome.