体外冲击波联合电针治疗冈上肌肌腱炎的临床研究

目的观察体外冲击波联合电针对冈上肌肌腱炎的临床疗效,探索其治疗机制。方法将60例冈上肌肌腱炎患者随机均分为电针组、冲击波组及联合治疗组。各组患者在治疗前、治疗1疗程结束后2周、4周、3月行VAS评定(休息、活动时)及Constant-Murley评定。结果各组患者治疗后各期VAS评分及C-M评分均较治疗前有改善,联合治疗组优于其他两组;冲击波组在治疗结束后2周VAS(休息)改善与电针组相近,但治疗结束后4周和3月优于电针组;冲击波组在治疗后VAS(活动)各期均优于电针组;冲击波组及联合治疗组随着时间延长VAS评分及C-M评分逐渐改善,但电针组治疗结束后3月却较2周及4周后VAS评分增高,C-M评分降低,提示病情可能反复。结论体外冲击波和电针对冈上肌肌腱炎都具有临床疗效,但联合治疗明显优于单一治疗,具有近期及远期疗效方面的共同优势,其既可弥补针灸治疗远期疗效差方面的不足,又能增强体外冲击波即时镇痛效应。

Clinical Effects of Etracorporeal Shock Wave and Electric Acupuncture on Supraspinatus Tendinitis

Objective: To observe the clinical effects and the mechanism of extracorporeal shock wave and electric acupuncture on supraspinatus tendinitis.Methods: 60 cases with supraspinatus tendinitis were randomly divided into the electric acupuncture group,the extracorporeal shock wave group and the combined treatment group.The visual analog scale(VAS) with evaluation of pain degree and the constant-murley(C-M) scale with assessment of shoulder function were detected before and 2 weeks,4 weeks,3 months after treatment.Results: VAS and C-M scale were improved after treatment at all phases in 3 groups.The improvement of the combined group was better than that of the electric acupuncture group and the extracorporeal shock wave group.There was no significance of VAS at rest in the electric acupuncture group and the extracorporeal shock wave group at 2 weeks after treatment.However,these scores of the extracorporeal shock wave group were superior to those of the electric acupuncture group at 4 weeks and 3 months after treatment.In the VAS of activity state,these scores of the extracorporeal shock wave group were better than those of the electric acupuncture group in the several periods.VAS and C-M scale were gradually improved in the extracorporeal shock wave group and the combined treatment group,However,it was relapse about disease that VAS scores at 3 months were high than those at 2 weeks and 4 weeks and C-M score were decreased in electric acupuncture group.Conclusion: The extracorporeal shock wave and the electric acupuncture have effects to supraspinatus tendinitis.The combined treatments can increase the short term and long term effects.Meanwhile,it can make up the insufficient on short term for electric acupuncture and improve the analgesia effects for ESWT.