基于软组织外科学理论发散式体外冲击波治疗足底筋膜炎的疗效分析

Enhanced efficacy of radical extracorporeal shockwave therapy for treatment of plantar fasciitis results from guidance of soft tissue surgery theory

摘要:

目的：观察依据软组织外科学理论能否提升发散式体外冲击波疗法（radial extracorporeal shockwave therapy, rESWT）治疗足底筋膜炎（plantar fasciitis, PF）的疗效。方法：60 例PF患者，随机分成2组，每组各30例。实验组接受患侧髋臀大腿根部联合足跟rESWT，对照组仅接受患侧足跟局部rESWT，每7天1次，共治疗4次。采用数字评价量表（numerical rating scale, NRS）和MaryLand评分评估患者首次治疗前、第4次治疗前、4 次治疗结束后随访1个月、3个月及6个月共5个时间点的疼痛程度和足部功能。结果：两组首次治疗后各时间点的NRS和MaryLand评分均较治疗前显著改善(P<0.05)，且实验组的NRS及MaryLand评分均优于对照组(P<0.05)。结论：rESWT可改善PF患者的疼痛及足部功能，遵循软组织外科学理论选择髋臀大腿根部联合足跟压痛点rESWT疗效优于足跟部。

Abstract:

Objective: To investigate whether the efficacy of radial extracorporeal shockwave therapy (rESWT) for plantar fasciitis (PF) could be improved owing to the guidance of soft tissue surgery theory. Methods: 60 patients with PF were randomly divided into 2 groups with 30 patients in each group. The experimental group received rESWT in the hip, thigh root and heel, and the control group only received rESWT in the heel, once every 7 days, a total of 4 times. Numerical rating scale(NRS) and MaryLand scores were used to evaluate the degree of pain and foot function before the 1st treatment, before the 4th treatment, and 1 month, 3 months and 6 months after 4 treatments. Results: The NRS and MaryLand scores after rESWT treatments in both groups were significantly improved compared with those before the 1st rESWT treatment in the same group(P<0.05). The NRS and MaryLand scores of the patients in experimental group were superior to those in control group after the 1st treatments(P<0.05). Conclusion: rESWT can improve both pain degree and foot function of patients with PF, the efficacy of rESWT in the hip, thigh root and heel is superior to that only in the heel.