体外冲击波联合电针治疗顽固性网球肘的临床研究

摘要

Objective It is to observe the clinical effects of combined treatments with extracorporeal shock wave treatment ( ESWT ) and electroacupuncture on refractory tennis elbow and further explore its treatment mechanism. Methods 60 cases of patients with refractory tennis elbow were randomly divided into electroacupuncture group, ESWT group and combined group with 20 cases in each group. Visual analog scale( VAS ) was used to evaluate the pain degree and activity daily life ( ADL ) was evaluated before and 2 weeks, 4 weeks, 3 months after treatment in all groups. Results The VAS and ADL were both obviously improved after treatment at all phases in the 3 groups( all P < 0.05 ), the improvement in combined group was more obviously than the other two groups( all P < 0.05 ). There was no significant difference in VAS and ADL between electroacupuncture group and ESWT group at 2 weeks after treatment, but they were better in ESWT group than that in electroacupuncture group at 4 weeks and 3 months after treatment( all P <0. 05 );VAS and ADL gradually improved in combined group and ESWT group with the treatment lasting, but worse at 3 months in electroacupuncture group than 4 weeks after treatment( P <0.05 ). Conclusion ESWT and electroacupuncture both have clinical curative effects on refractory tennis elbow, combined treatments can increase the short term and long term effects, and it can make up the insufficient on short term for electroacupuncture and improve the analgesia effects for ESWT.%目的 观察体外冲击波联合电针治疗顽固性网球肘的临床疗效,进一步探索体外冲击波治疗机制.方法 将60例顽固性网球肘患者随机分为电针组、冲击波组及联合治疗组,每组20例.3组患者在治疗前及治疗结束后2周、4周、3个月分别进行VAS疼痛评分及日常生活能力(ADL)评定.结果 3组患者治疗后各期VAS评分及ADL评分均较治疗前明显改善(P均<0.05),且联合治疗组改善程度优于单纯电针组及冲击波组(P均<0.05);治疗后2周,冲击波组与电针组VAS评分及ADL评分比较均无明显差异,治疗后4周和3个月均优于电针组(P均<0.05);冲击波组及联合治疗组随着时间延长,VAS评分及ADL评分进一步改善,但是电针组3个月后却较4周后有变差倾向(P<0.05).结论 体外冲击波和电针对顽固性网球肘都具有临床疗效,但二者联合治疗效果明显优于单一治疗,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的不足,又能增强冲击波的即时镇痛效应.