發(fā)布時(shí)間：2018-01-21 14:15

  本文關(guān)鍵詞： 跟腱炎 體外沖擊波 局部封閉療法　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究通過分析跟腱炎患者治療前后的評(píng)分?jǐn)?shù)據(jù),觀察比較體外沖擊波療法與局部封閉療法治療跟腱炎之間的臨床療效,旨在為體外沖擊波治療跟腱炎研究提供客觀依據(jù),從而為跟腱炎患者提供新型顯效快、療效好、痛苦少的代替方法。方法選擇就診于福建省南平市第一醫(yī)院符合納入與排除標(biāo)準(zhǔn)的38例跟腱炎患者作為受試者,隨機(jī)分為體外沖擊波治療組(試驗(yàn)組)、局部封閉療法治療組(對(duì)照組)。試驗(yàn)組接受瑞士 Dolor Clast EMS體外沖擊波治療,能流密度0.16mJ/mm2,治療壓力2-3bar,沖擊波次數(shù)2000次,手持壓力低-中,沖擊頻率5-10hz,治療時(shí)間10min;每周治療1次,共3次。對(duì)照組接受醋酸曲安奈德聯(lián)合2%鹽酸利多卡因注射液的痛點(diǎn)局部封閉注射療法,每周治療1次,共2次。體外沖擊波組患者在第1次治療(首次治療)、第2次治療、第3次治療(療程結(jié)束時(shí))、療程結(jié)束后6周均進(jìn)行評(píng)估。局部封閉療法組患者分別在首次治療、療程結(jié)束時(shí)、療程結(jié)束后6周進(jìn)行評(píng)估。評(píng)估方法主要采用視覺模擬評(píng)分(Visual Analogue Scale,VAS)、維多利亞學(xué)院足踝運(yùn)動(dòng)功能評(píng)估評(píng)分(Victorian Institute of Sport Assessment Score-Achillea,VISA-A)。結(jié)果本研究38例患者中,因部分患者未完成隨訪以及中斷治療予以剔除,最終納入患者31例。(1)兩組患者在接受治療前,一般資料(年齡、性別)和臨床資料(病程、VAS評(píng)分、VISA-A評(píng)分)比較分析,兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)兩組患者在治療前VAS評(píng)分、VISA-A評(píng)分相近,在首次治療、療程結(jié)束時(shí)及療程結(jié)束后6周不同時(shí)期的VAS評(píng)分較治療前明顯降低,VISA-A評(píng)分較治療前明顯增高,其前后差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)在首次治療結(jié)束時(shí),局部封閉療法組VAS評(píng)分、VISA-A評(píng)分均優(yōu)于體外沖擊波治療組,兩組之間有統(tǒng)計(jì)學(xué)意義(P0.05)。療程結(jié)束時(shí)、療程結(jié)束后6周,兩組患者之間的VAS評(píng)分、VISA-A評(píng)分基本相近,兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(4)在第1次治療、第2次治療、第3次治療,體外沖擊波治療組患者的VAS評(píng)分、VISA評(píng)分隨著治療時(shí)間變化而變化,后期治療效果均優(yōu)越于前期治療效果,不同時(shí)間點(diǎn)之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論體外沖擊波療法與局部封閉療法兩組治療方案治療跟腱炎的臨床療效具有等效性,局部封閉療法在短期內(nèi)治療跟腱炎顯效速度較體外沖擊波療法快,但是體外沖擊波療法在遠(yuǎn)期療效上具有累積效應(yīng),鑒于體外沖擊波的安全性,體外沖擊波療法更值得臨床推薦。
[Abstract]:Objective to observe and compare the clinical efficacy of extracorporeal shock wave therapy (ESWT) and local blocking therapy (LCT) in the treatment of Achilles tendon by analyzing the scoring data before and after treatment of Achilles tendinitis. The aim is to provide objective basis for the study of extracorporeal shock wave in the treatment of Achilles tendinitis, thus providing a new type of remarkable effect and good curative effect for the patients with Achilles tendinitis. Methods 38 patients with Achilles tendinitis who met the criteria of inclusion and exclusion were randomly divided into extracorporeal shock wave treatment group (experimental group). The experimental group was treated with Dolor Clast EMS extracorporeal shock wave (ESWL), and the energy flow density was 0.16mJ / mm2. The treatment pressure was 2 ~ 3 bar. the shock wave was 2 000 times, the handheld pressure was low-medium, the shock frequency was 5-10 h / z, the treatment time was 10 min; The control group was treated with triamcinolone acetonide acetate combined with 2% lidocaine hydrochloride injection once a week. Two times. The patients in the extracorporeal shock wave group were treated at the first time (the first treatment, the second treatment, and the third treatment) (at the end of the course of treatment). The patients in the local block therapy group were treated for the first time and at the end of the course of treatment. Six weeks after the end of the course of treatment, the main evaluation methods were visual Analogue scale scale (VAS). Victoria College foot and ankle motor function assessment scale (. Victorian Institute of Sport Assessment Score-Achillea. Results among 38 patients in this study, 31 patients were included in the study before treatment because some patients were not followed up and interrupted treatment was eliminated. General data (age, sex) and clinical data (course of disease / VAS score / VISA-A score) were compared and analyzed. There was no significant difference between the two groups (P0.05. 2) the VAS score and VISA-A score of the two groups were similar before treatment, and they were treated for the first time. The VAS scores at the end of the course and 6 weeks after the treatment were significantly lower than those before treatment, and the scores of VISA-A were significantly higher than those before treatment. At the end of the first treatment, the VAS score and VISA-A score of the local block therapy group were better than that of the extracorporeal shock wave group. At the end of the course of treatment, 6 weeks after the end of the course of treatment, the VAS score and VISA-A score were similar between the two groups. There was no significant difference between the two groups in the VAS score of the patients in the first, second and third treatment groups. The VISA score changed with the change of treatment time, and the effect of later treatment was superior to that of early treatment. Conclusion the two groups of extracorporeal shock wave therapy and local blocking therapy are effective in the treatment of Achilles tendinitis. Local blocking therapy is more effective than extracorporeal shock wave therapy in the short term, but ESWT has cumulative effect in the long term, in view of the safety of extracorporeal shock wave. Extracorporeal shock wave therapy is more worthy of clinical recommendation.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R686.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳穗瓊;黃崇俠;蔡源輝;李錦海;朱偉亮;;低能量體外沖擊波治療髕腱末端病累積效應(yīng)觀察[J];承德醫(yī)學(xué)院學(xué)報(bào);2016年05期

2 李圣節(jié);王瑞;李飛;王峰;肖紅雨;;視覺反饋下離心收縮鍛煉治療跟腱病的療效觀察[J];解放軍醫(yī)學(xué)院學(xué)報(bào);2016年09期

3 黃合琴;楊柳;段小軍;陳光興;郭林;何銳;;體外沖擊波治療跟腱腱病的臨床療效研究[J];重慶醫(yī)學(xué);2015年05期

4 薛慧琴;;MASTERPULS MP100型體外沖擊波治療儀治療跟腱痛的臨床觀察[J];內(nèi)蒙古醫(yī)學(xué)雜志;2014年04期

5 楊學(xué)橋;潘洪閣;王銘;;足跟內(nèi)側(cè)弧形小切口在跟腱炎微創(chuàng)手術(shù)中的應(yīng)用[J];局解手術(shù)學(xué)雜志;2013年05期

6 張盤德;彭小文;容小川;尹杰;;體外沖擊波治療網(wǎng)球肘的鎮(zhèn)痛效果研究[J];中國(guó)康復(fù)醫(yī)學(xué)雜志;2013年01期

7 唐康來;陳磊;;跟腱病的外科治療策略[J];中國(guó)骨與關(guān)節(jié)外科;2012年04期

8 杜鋒;張志杰;朱毅;劉春龍;李凝;;肌肉離心訓(xùn)練結(jié)合康復(fù)治療跟腱炎的臨床觀察[J];中華全科醫(yī)學(xué);2012年08期

9 裘超;洪建軍;毛誠(chéng)晃;盧曉郎;;局部注射骨髓間充質(zhì)干細(xì)胞和曲安奈德治療兔跟腱炎的效果對(duì)比[J];中國(guó)組織工程研究;2012年14期

10 姚偉;華英匯;陳世益;李云霞;戈允申;;體外沖擊波治療跟腱止點(diǎn)腱病和非止點(diǎn)腱病的療效對(duì)比分析[J];中國(guó)運(yùn)動(dòng)醫(yī)學(xué)雜志;2012年01期

相關(guān)碩士學(xué)位論文 前1條

1 李志國(guó);沖擊波對(duì)肌腱修復(fù)及其相關(guān)生長(zhǎng)因子表達(dá)的影響[D];河北醫(yī)科大學(xué);2009年

，

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