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目的观察发散式冲击波联合手法对桡骨茎突狭窄性腱鞘炎的治疗效果。方法选择2015年8月至2017年1月安徽医科大学第二附属医院康复医学科治疗桡骨茎突狭窄性腱鞘炎患者35例,其中男性9例,女性26例;年龄25~65岁,平均年龄44.6岁。随机分为治疗组和对照组。治疗组18例,其中男性4例,女性14例;年龄(43.5±4.8)岁;病程(2.1±1.3)个月。对照组17例,其中男性5例,女性12例;年龄(45.2±5.6)岁;病程(1.9±1.1)个月。对照组采用常规手法治疗,治疗组在手法治疗的基础上加用发散式冲击波治疗。比较两组患者治疗前、治疗1周后、2周后的疼痛视觉模拟量表(VAS)评分、患者自我腕关节功能评价(PRWE)评分,并评价1个月后两组的疗效。结果治疗1周后和2周后治疗组VAS评分分别为(2.5±1.2)分、(1.7±0.6)分,PRWE评分分别为(48.3±4.2)分、(21.2±2.6)分;较治疗前明显改善,差异有统计学意义(P<0.05);对照组VAS评分分别为(5.4±1.1)分、(3.9±1.2)分,PRWE评分分别为(63.1±6.7)分、(45.7±7.4)分。治疗组优于对照组,差异有统计学意义(P<0.05)。对照组1周后VAS评分及PRWE评分较治疗前无明显改善(P>0.05),2周后VAS评分及PRWE评分较治疗前明显改善,差异有统计学意义(P<0.05);治疗组1个月后有效率及痊愈率均高于对照组(89%vs 76%、56%vs 29%),差异均有统计学意义(P<0.05)。结论冲击波联合手法治疗可有效促进桡骨茎突狭窄性腱鞘炎患者损伤部位的修复,能快速减轻疼痛、改善腕部功能。
Objective To observe the therapeutic effect of divergent shock wave on the treatment of stenosing tenosynovitis of radial styloid process. Methods From August 2015 to January 2017, 35 patients with stenosing tenosynovitis of radial styloid were treated in the Second Affiliated Hospital of Anhui Medical University, including 9 males and 26 females, aged from 25 to 65 years with a mean age of 44.6 year old. Randomly divided into treatment group and control group. The treatment group of 18 patients, including 4 males and 14 females; age (43.5 ± 4.8) years; duration (2.1 ± 1.3) months. Control group of 17 patients, including 5 males and 12 females; age (45.2 ± 5.6) years; duration (1.9 ± 1.1) months. The control group was treated by conventional method, and the treatment group was treated with divergent shock wave based on the manual treatment. The pain visual analog scale (VAS) score, PRWE score, and the efficacy of the two groups after 1 month and 2 weeks of treatment were compared between the two groups. Results The VAS scores of the treatment group after one week and two weeks after treatment were (2.5 ± 1.2) and (1.7 ± 0.6) points respectively, and the PRWE scores were (48.3 ± 4.2) and (21.2 ± 2.6) points respectively. (P <0.05). The VAS scores of the control group were (5.4 ± 1.1) and (3.9 ± 1.2) points respectively, and the PRWE scores were (63.1 ± 6.7) and (45.7 ± 7.4) Minute. The treatment group was better than the control group, the difference was statistically significant (P <0.05). The VAS score and PRWE score of the control group after 1 week were not significantly improved (P> 0.05), and the VAS score and PRWE score were significantly improved after 2 weeks (P <0.05). The treatment group 1 After one month, the effective rate and recovery rate were higher than those in the control group (89% vs 76%, 56% vs 29%, respectively). The differences were statistically significant (P <0.05). Conclusions Shockwave combined manipulation can effectively promote the repair of injured parts of patients with stenosing tenosynovitis of radial styloid process, and can quickly relieve pain and improve wrist function.