发散式体外冲击波疗法联合常规物理因子治疗中年慢性非特异性腰背痛患者的临床疗效

摘要/Abstract

摘要： 目的探究发散式体外冲击波疗法（ESWT）联合常规物理因子治疗中年慢性非特异性腰背痛（CNLBP）的临床疗效。方法选取2020年7月~2021年6月在上海市虹口区江湾医院接受康复治疗的60例中年CNLBP患者,采用随机数表法将其分为对照组和试验组,每组30例。对照组进行常规物理因子治疗,包括干扰电治疗、微波治疗与超声波治疗,试验组在对照组治疗的基础上增加中等能量强度的发散式体外冲击波进行治疗。两组患者分别在治疗前、治疗4周后、治疗8周后,进行视觉模拟评分法（visual analogue scale,VAS）、Oswestry功能障碍指数（Oswestry disability index,ODI）、指地距离（finger face to distance,FFD）的评估,了解患者的腰痛程度和腰椎功能状况,并观察两组的安全性。结果治疗前,两组患者的各项评估结果比较,差异无统计学意义（P>0.05）。治疗4周和8周后,两组患者的VAS评分、ODI、FFD均有所降低,且试验组分值较对照组更低,差异有统计学意义（P<0.05）。两组患者在治疗期间均未产生不良反应。结论 ESWT联合常规物理因子治疗CNLBP能够有效缓解患者的疼痛,从而改善其腰椎功能。

关键词: 发散式体外冲击波疗法, 慢性非特异性腰背痛, 中年, 中能量

Abstract: Objective To explore the clinical efficacy of divergent extracorporeal shock wave therapy (ESWT) combined with conventional physical agents therapy in middle-aged patients with chronic non-specific low back pain (CNLBP). Methods The 60 middle-aged CNLBP patients undergoing rehabilitation in Jiangwan Hospital of Shanghai Hongkou District from July 2020 to June 2021 were divided into control group and experimental group by random number table method, with 30 cases in each group. The control group performed conventional physical agents therapy, including interference electric therapy, microwave therapy and ultrasound therapy, and the experimental group added the divergent extracorporeal shock wave therapy with intermoderate energy intensity to the basis of the control group treatment. Before treatment, 4 weeks after treatment and 8 weeks after treatment, visual analogue scale(VAS),Oswestry dysfunction index (ODI), finger face to distance (FFD) were adopted to evaluate the degree of low back pain and lumbar spine function, and observe the safety of the two groups. Results Before treatment, there was no significant difference between the two groups (P>0.05). After 4 weeks and 8 weeks of treatment, VAS, ODI, and FFD were reduced in both groups (P<0.05), and the experimental group values were lower than those in the control group (P<0.05). Both groups of patients had no adverse reactions during the treatment. Conclusion Divergent extracorporeal shock wave therapy combined with conventional physical agents therapy can effectively relieve the pain in middle-aged patients with chronic non-specific low back pain and thus improve their lumbar spine function.

Key words: divergent extracorporeal shock wave therapy, chronic non-specific low back pain, middle age, intermoderate energy

中图分类号:

R493

施琦, 胡安迪, 罗振东. 发散式体外冲击波疗法联合常规物理因子治疗中年慢性非特异性腰背痛患者的临床疗效[J]. 中华养生保健, 2022, 40(23): 4-7.

SHI Qi, HU An-di, LUO Zhen-dong. The Clinical Efficacy of Divergent Extracorporeal Shock Wave Therapy Combined with Conventional Physical Agents Therapy in Middle-Aged Patients with Chronic Non-Specific Low Back Pain[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(23): 4-7.

参考文献

[1] 王连成,章礼勤,许世波,等.腰痛患者和健康人动态平衡功能的研究[J].中国康复医学杂志,2015,30(7):720-722.
[2] Vlaeyen J W S, Maher C G, Wiech K, et al. Low back pain[J]. Nature reviews Disease primers, 2018,4(1):52.
[3] 中国康复医学会脊柱脊髓专业委员会,中华医学会骨科学分会骨科康复学组.中国非特异性腰背痛临床诊疗指南[J].中国脊柱脊髓杂志,2022,32(3):258-268.
[4] Itz C J, Geurts J W, van Kleef M, et a1. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care[J], Eur J Pain,2013,17(1):5-15.
[5] 王宁,李丽,丁懿,等.体外冲击波治疗对慢性腰痛病人疼痛、功能障碍和抑郁的影响[J].中国疼痛医学杂志,2019,25(8):630-634.
[6] 李雯燕,武俊英.体外冲击波联合悬吊运动训练治疗慢性腰痛的临床疗效及对静态平衡能力的影响[J].中国民康医学,2018,30(8):14-16.
[7] 李亨,郑军.慢性下腰痛临床病因学研究[J].亚太传统医药,2016, 12(20):49-51.
[8] 冷波. 经颅直流电刺激联合集体运动疗法治疗慢性腰痛的疗效[J].颈腰痛杂志,2022.43(1):106-108.
[9] 印杰松,陆桂伟.表面肌电生物反馈指导对慢性非特异性腰背痛康复训练的疗效影响[J].颈腰痛杂志,2019,40(5):687-689.
[10] 王永召,周云,吴建贤.体外冲击波治疗肌肉骨骼疼痛的研究进展[J].中华临床医师杂志(电子版),2017,11(7):1216-1220.
[11] 中国研究型医院学会冲击波医学专业委员会.中国骨肌疾病体外冲击波疗法指南(2019年版)[J].中国医学前沿杂志(电子版),2019,11(4):1-10.
[12] 中国康复医学会脊柱脊髓专业委员会专家组.中国急／慢性非特异性腰背痛诊疗专家共识[J].中国脊柱脊髓杂志,2016,26(12):1134-1138.
[13] 李阔,张春艳,刘颜.慢性非特异性下腰痛个体化康复治疗的临床疗效分析[J].中国生化药物杂志,2016,6(36):188-190.
[14] Moseley G L, Hodeges P W.Reduced variability of postural strategy prevents normalization of motor changes induced by back pain:a risk factor feor chronic trouble[J]. Behav Neurosci,2006,120(2):474-276.
[15] 于瑞,许轶,王楚怀,等.慢性非特异性下背痛患者悬吊运动疗法治疗后表面肌电信号的变化[J].中国康复医学杂志,2015,30(8):801-803.
[16] Maffulli N, Longo L G, Denaro V.Novel approaches for the man agement of tendinopathy[J]. J Bone Joint Surg Am,2010,92(15):2604-2613.
[17] 李祖红,李洁,朱耀刚,等.体外冲击波治疗慢性非特异性下背痛的疗效观察[J].中华物理医学与康复杂志,2019,41(7):501-503.
[18] 叶丛,陈木升,李海珊,等.体外冲击波治疗仪和传统综合治疗方法在上肢慢性损伤性疼痛中的应用对比[J].现代诊断与治疗,2019,30(8):1313-1315.
[19] Saggini R, Di Stefano A, Saggini A, et al.Clinical application of shock wave therapy in musculoskeletal disorders: Part I[J]. J Biol Regul Homeost Agents,2015,29(3):533-545.
[20] Claudio L S, Joseph P, William M, et al.Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine[J]. J Clin Orthop Trauma,2020,11(Suppl 3):S309-S318.
[21] 李占标,吕运良,马飒飒,等.体外冲击波治疗经皮内镜下腰椎间盘摘除术后患者腰部疼痛的疗效观察[J].中华物理医学与康复杂志,2022,44(3):254-256.