体外冲击波与超声波治疗跟痛症疗效对照研究

A comparison of the effectiveness of extracorporeal shock wave therapy and ultrasound therapy on managing heel pain

目的 比较体外冲击波与超声波两种治疗方法对跟痛症患者的疗效。方法 3 7名跟痛症患者被分为外冲击波治疗组 (冲击波组 )、超声波治疗组 (超声波组 )与对照组。冲击波治疗选用频率 4Hz ,强度0 .2 3～ 0 .3 7mJ/mm2 ,每次冲击 10 0 0次 ,治疗时间约 15min ,每周 1次 ,共 3次 ;超声波治疗选用频率 1MHz ,强度 1W /cm2 ,每次治疗 5min ,每周 3次 ,共治疗 9次 ,治疗部位均为患侧足跟后部。采用视觉模拟评级法 (VAS )评估患者双足负重时的疼痛强度 ,包括早晨起床时、最长持续行走或站立后、足底牵拉及足跟受压检查 ,每次检查时记录患者 1周内最长可持续行走或站立时间。结果 患者治疗 3周后及治疗后 3周随访发现 ,足底牵拉检查、足跟受压检查和患者最长可持续行走或站立时间均显示体外冲击波疗法效果显著。结论 体外冲击波治疗跟痛症的疗效优于超声波治疗 。

Objective To examine the relative effectiveness of extracorporeal shock wave therapy (ESWT) and ultrasound therapy (US) on managing heel pain. Methods Thirty seven patients were divided into 3 groups, two treatment groups (groups 1 and 2) and one control group (group 3).Group 1 received ESWT once a week for 3 consecutive weeks.Parameters were set at a frequency of 4Hz with a total of 1000 impulses, intensity at 0.23 to 0.37mJ/mm 2. Group 2 received continuous ultrasound therapy for 5 minutes in each session, three times a week for three consecutive weeks. Parameters were set at 1MHz, intensity level at 1W/mm 2. Group 3 was the control group and no treatment was given during the study period.The intensity of morning pain on weight bearing, pain triggered by prolonged walking/standing, pain on tension and palpation tests were assessed by use of Visual Analogue Scale (VAS) before and after each treatment session, including the follow up session.In addition, Mayo Clinical Scoring System (MCSS) was used to evaluate the treatment outcomes. Results After 3 weeks of treatment plus 3 weeks follow up,outcome measures had shown statistical significant difference on the intensity of pain on tension test( P =0.037),the intensity of pain on palpation test ( P =0.019) and the maximum duration of prolonged walking or standing ( P =0.002). Conclusion ESWT is more effective and efficient for managing heel pain than ultrasound therapy.