不同剂量体外冲击波治疗肱骨外上髁炎的疗效对比

目的 比较不同能流密度的体外冲击波(extracorporeal shock wave, ESW)治疗肱骨外上髁炎(lateral epicondylitis, LE)的短期临床疗效，探索ESW的最佳治疗剂量。方法 将120例LE患者分为A、B、C和D 4组，均使用ESW治疗4周，各组的能流密度分别为0.06、0.08、0.10、0.12 mJ/mm²。分别在治疗前及治疗后4、24及48周，比较4组患者疼痛视觉模拟量表(visual analogue scale, VAS)评分、肱骨外上髁炎功能评估(patient-rated tennis elbow evaluation, PRTEE)评分及末次随访患者满意度和复发率。结果 按时间点比较，各组VAS评分治疗前最高，治疗后48周降至最低(P<0.05),4组患者满意度及复发率比较差异无统计学意义(P>0.05),但C组患者满意度(96.67%)明显高于A组(80%),差异具有统计学意义(P=0.04)。按组间比较观察，治疗前各组患肘VAS评分差异无统计学意义(P>0.05);治疗后4、24和48...

Comparison of different doses of extracorporeal shock wave on the treatment of lateral epicondylitis

Objective To compare the short-term clinical efficacy of extracorporeal shock wave (ESW) with different energy densities on the treatment of lateral epicondylitis (LE), and to explore the optimal therapeutic dose of ESW. Methods Totally 120 cases of LE were divided into four groups, Group A, B, C and D. All cases were treated with ESW for 4 weeks. The energy flow densities of each group were 0.06,0.08,0.10 and 0.12 mJ/mm2. Before treatment, and 4 weeks, 24 weeks and 48 weeks after treatment, the pain of visual analogue scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE) score, satisfaction and recurrence rate of the patients in the last follow-up were compared among the 4 groups. Results The VAS score of each group was the highest before treatment and decreased to the lowest 48 weeks after treatment. There was no significant difference in satisfaction and recurrence rate among the 4 groups, but the satisfaction in Group C (1/30) was significantly lower than that in Group A (6/30) (P<0.05). According to the comparison among groups, there was no significant difference in the VAS of LE among them before treatment, but the VAS and PRTEE scores decreased gradually 4 weeks, 24 weeks and 48 weeks after treatment. The VAS score was the lowest in Group C, and followed with Group D, Group B and Group A, with significant difference among them (P<0.001). Besides, PRTEE was the lowest in group C, and followed with Group D, Group B and Group A, with significant difference among them (P<0.05). Conclusion Low-medium energy ESWT can effectively alleviate pain symptoms and improve elbow joint function in patients with lateral epicondylitis, with lower recurrence rate and higher satisfaction. The optimal short-term clinical efficacy could be obtained by using 0.10 mJ/mm2 of energy density.