半导体激光照射联合中药薰洗治疗慢性跟腱末端病

目的：观察半导体激光照射联合中药薰洗治疗慢性跟腱末端病的临床疗效和安全性.方法：将76例慢性跟腱末端病患者随机分为治疗组和对照组,每组38例.治疗组采用半导体激光照射联合中药薰洗治疗,对照组采用依托芬那酯凝胶局部外涂治疗.记录并比较2组患者不良反应的发生情况,并于治疗1个月后评价2组患者的跟腱末端疼痛情况及临床疗效.分别于治疗结束后3个月、6个月电话随访2组患者的复发情况.结果：①跟腱末端疼痛评分.治疗前2组患者跟腱末端疼痛评分比较,差异无统计学意义[（7.26±0.51）分,（7.31±0.43）分,t=0.462,P=0.645];治疗组治疗前后跟腱末端疼痛评分的差值大于对照组[（5.12±0.47）分,（2.68±0.55）分,t=20.790,P=0.000].②临床疗效.治疗组治愈5例、显效25例、有效8例,对照组显效7例、有效23例、无效8例.2组患者临床疗效比较,治疗组优于对照组（Z=-5.462,P=0.000）.③复发率.治疗结束后3个月随访时,2组患者复发率比较,差异无统计学意义（χ2=1.629,P=0.202）;治疗结束后6个月随访时,治疗组复发率低于对照组（χ2=6.333,P=0.012）.④安全性.治疗组未出现明显不良反应,对照组4例出现皮肤过敏反应.2组患者不良反应发生率比较,差异无统计学意义（P=0.058）.结论：采用半导体激光照射联合中药薰洗治疗慢性跟腱末端病,能够缓解跟腱末端疼痛,疗效确切,短期内复发率低,安全性高,值得临床推广应用.

Clinical study on the semiconductor laser therapy combined with Chinese herbal steaming and washing therapy in the treatment of chronic enthesiopathy of Achilles tendon

Objective：To observe the clinical curative effect and safety of semiconductor laser therapy combined with Chinese herbal steaming and washing therapy in the treatment of chronic enthesiopathy of Achilles tendon. Methods ： Seventy-six patients with chronic enthesi- opathy of Achilles tendon were randomly divided into treatment group and control group,38 cases in each group. Patients in treatment group were treated with semiconductor laser therapy combined with Chinese herbal steaming and washing therapy, while the others in control group were treated with external application of etofenamate gel. Adverse reactions were recorded and compared between the 2 groups, and the pain scores of Achilles tendon terminal and clinical effects were compared between the 2 groups after one-month treatment. The recurrence rate were assessed by telephone interview questionnaires at 3 and 6 months after the end of the treatment. Results ：There was no statistical difference in the Achilles tendon terminal pain scores between the 2 groups before the treatment （ 7.26 ＋/- 0.51 vs 7.31 ＋/- 0.43 points, t = 0. 462, P = 0.645）. The differences of Achilles tendon terminal pain scores between pre - treatment and post-treatment of treatment group were larger than that of the control group （5.12 ＋/-0.47 vs 2, 68 ＋/-0.55 points, t = 20. 790,P = 0.000）. Five patients obtained an excellent result ,25 good, and 8 fair in the treatment group,while 7 patients obtained an good result,23 fair, and 8 poor in the control group. The treatment group sur- passed the control group in the clinical effect（Z = -5. 462,P =0.000）. There was no statistical difference in recurrence rate between the 2 groups at 3 months after the end of the treatment（x^2 = 1. 629,P =0. 202） ,and the recurrence rate was lower in treatment group compared with the control group at 6 months after the end of the treatment （x^2 = 6. 333,P = 0.012）. No obvious adverse reactions were found in the treatment group ,while 4 cases with cutaneous anaphylaxis were found in the control group. There was no statistical difference in incidence of adverse re- action between the 2 groups （P = 0. 058 ）. Conclusion ：It can relieve the pain in Achilles tendon terminal by application of semiconductor laser therapy combined with Chinese herbal steaming and washing therapy in the treatment of chronic enthesiopathy of Achilles tendon. Further- more,it has certain curative effects with low recurrence rate in short-term and high safety,so it is worthy of popularizing in clinic.