体外冲击波疗法结合推拿治疗腰臀部软组织损伤的临床研究
发布时间：2018-09-19 15:15
【摘要】：研究目的:本研究采用临床随机对照研究方法,探讨体外冲击波疗法结合推拿治疗腰臀部软组织损伤的治疗效果,并评估该方法的临床疗效及安全性,为临床治疗腰臀部软组织损伤患者寻找一种无创、有效、安全兼顾的治疗方法,并在临床上推广。研究方法:将符合纳入标准及排除标准的腰臀部软组织损伤患者40例,按照临床就诊先后顺序随机分为治疗组和对照组,每组各20例。2组患者均在推拿治疗基础上,治疗组采用冲击波治疗,每5天治疗1次,每次10-20分钟,共治疗4周6次;对照组予以电脑中频理疗疗法,每周治疗3次,隔天1次,每次治疗20分钟,共治疗4周12次。两组均以局部压痛点和肌紧张带为治疗位置。分别于治疗前、第一次治疗后、第1周、第2周、第4周五个时间点观察评分,以简式McGill疼痛问卷中的情感类、感觉类、视觉模拟定级(VAS)、现在疼痛状况(PPI)四项指标评估患者病情变化。并在治疗过程中注意观察患者是否有不良反应,如皮肤瘀斑、皮下血肿、心悸等。研究治疗结束后把所有数据资料输入SPSS22.0统计软件进行统计数据分析,计量资料采用t检验;计数资料采用卡方检验或秩和检验。以P0.05为差异有统计学意义。研究结果:1.本研究纳入的40例患者,治疗期间无脱落或剔除,共完成40例。两组患者治疗前的一般资料(性别、年龄、病程)、简式McGill疼痛问卷中情感类、感觉类、视觉模拟定级(VAS)、现在疼痛状况(PPI)四项指标评分均无统计学意义(P0.05),两组具有可比性。2.VAS疗效评估方面:治疗组总有效率100%,对照组总有效率90%,两组的比较具有统计学意义(P0.05)。3.两组4周治疗结束后简式McGill疼痛问卷中情感类、感觉类、视觉模拟定级(VAS)、现在疼痛状况(PPI)四项指标评分与各组治疗前评分进行比较,均有下降,具有统计学意义(P0.05),说明两组治疗均有效。4.第1次治疗后,治疗组在感觉类、VAS、PPI项疼痛改善情况优于对照组(P0.05),情感类指标评分比较无统计学意义。5.第1周治疗后,治疗组在感觉类、VAS项疼痛改善方面要优于对照组(P0.05);其余指标差异无统计学意义。6.第2周治疗后,治疗组在情感类、感觉类、VAS项疼痛缓解疗效方面要优于对照组(P0.05);PPI指标评分比较无统计学差异。.7.第4周治疗后,两组各项指标评分比较均具有统计学意义(P0.05),说明第4周治疗后治疗组疗效要优于对照组。8.治疗过程中治疗组有2例患者第1次治疗后第2天出现治疗部位稍肿痛现象,无其他不适,予以冰敷和适当休养后经2-3天后症状可消失,并且不影响下一次的治疗,其余患者在治疗期间均未出现明显不良反应。结论:1.冲击波疗法结合推拿手法能够有效治疗腰臀部软组织损伤。2.与电脑中频理疗疗法相比,冲击波疗法的即时和近期疗效更好,治疗次数少,耗时更少。3.冲击波疗法联合推拿是治疗腰臀部软组织损伤的一种起效快、临床有效的治疗方法,值得在临床上推广应用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of extracorporeal shock wave therapy combined with massage in the treatment of lumbar and hip soft tissue injury. To seek a noninvasive, effective and safe treatment method for the patients with soft tissue injury of waist and hip, and to promote it in clinic. Methods: forty patients with soft tissue injury of waist and hip were randomly divided into treatment group and control group according to the order of clinical visit. 20 cases in each group were treated with massage. The treatment group was treated with shock wave once every 5 days for 10-20 minutes for a total of 4 weeks and 6 times, while the control group was treated with computer medium frequency physiotherapy 3 times a week, once every other day for 20 minutes, for a total of 4 weeks and 12 times. Both groups were treated with local tenderness and muscle tension zone. The scores were observed at five time points before treatment, after the first treatment, at week 1, week 2, week 4, respectively. The emotional and sensory categories of the simple McGill pain questionnaire were used. Visual analogue grade (VAS), is now evaluating the changes of the patient's condition by four indexes of (PPI). During the course of treatment, the patients were observed whether there were adverse reactions, such as skin ecchymosis, subcutaneous hematoma, palpitation and so on. After the treatment, all the data were input into the SPSS22.0 statistical software for statistical data analysis, the measurement data were analyzed by t test, and the count data were analyzed by chi-square test or rank sum test. P0.05 as the difference was statistically significant. The result of the study was: 1. The 40 patients included in this study had no exfoliation or elimination during treatment, and 40 patients were completed. The general data (sex, age, course of disease) of the two groups before treatment, emotional class, sensory type in the simple McGill pain questionnaire, Visual analogue grade (VAS), has no statistical significance (P0.05). 2. Evaluation of the curative effect of (VAS),: the total effective rate of the treatment group was 100 and the total effective rate of the control group was 90. The comparison between the two groups was statistically significant (P0.05). In the simple McGill pain questionnaire after 4-week treatment, the scores of emotion, sensation and visual analogue grade (VAS), were compared with the scores before treatment. There was statistical significance (P0.05), indicating that the two groups of treatment are effective. 4. After the first treatment, the pain improvement of VAS-PPI in the treatment group was better than that in the control group (P0.05), and there was no significant difference in the scores of affective indexes. 5. 1 week after treatment, the treatment group in sensory VAS pain improvement was better than the control group (P0.05), the other indicators were not statistically significant. 6. After the second week of treatment, the treatment group in the emotional category, sensory VAS pain relief effect was better than the control group (P0.05) PPI scores compared with no statistical difference. Four weeks after treatment, the two groups were statistically significant (P0.05), indicating that the treatment group after the 4th week treatment was better than the control group. 8. In the treatment group, 2 patients in the treatment group had slight swelling and pain on the second day after the first treatment, without any other discomfort. The symptoms could disappear after 2-3 days after the ice compress and proper recuperation, and the next treatment would not be affected. No significant adverse reactions were observed in other patients during treatment. Conclusion 1. Shock wave therapy combined with massage manipulation can effectively treat soft tissue injury of waist and hip. Shock wave therapy is more effective in the immediate and short term, less time consuming and less time consuming than computer medium frequency physiotherapy. Shock wave therapy combined with massage is an effective and effective method for the treatment of soft tissue injury of waist and hip, which is worth popularizing in clinic.
【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R685
本文编号：2250505
[Abstract]:Objective: to evaluate the clinical efficacy and safety of extracorporeal shock wave therapy combined with massage in the treatment of lumbar and hip soft tissue injury. To seek a noninvasive, effective and safe treatment method for the patients with soft tissue injury of waist and hip, and to promote it in clinic. Methods: forty patients with soft tissue injury of waist and hip were randomly divided into treatment group and control group according to the order of clinical visit. 20 cases in each group were treated with massage. The treatment group was treated with shock wave once every 5 days for 10-20 minutes for a total of 4 weeks and 6 times, while the control group was treated with computer medium frequency physiotherapy 3 times a week, once every other day for 20 minutes, for a total of 4 weeks and 12 times. Both groups were treated with local tenderness and muscle tension zone. The scores were observed at five time points before treatment, after the first treatment, at week 1, week 2, week 4, respectively. The emotional and sensory categories of the simple McGill pain questionnaire were used. Visual analogue grade (VAS), is now evaluating the changes of the patient's condition by four indexes of (PPI). During the course of treatment, the patients were observed whether there were adverse reactions, such as skin ecchymosis, subcutaneous hematoma, palpitation and so on. After the treatment, all the data were input into the SPSS22.0 statistical software for statistical data analysis, the measurement data were analyzed by t test, and the count data were analyzed by chi-square test or rank sum test. P0.05 as the difference was statistically significant. The result of the study was: 1. The 40 patients included in this study had no exfoliation or elimination during treatment, and 40 patients were completed. The general data (sex, age, course of disease) of the two groups before treatment, emotional class, sensory type in the simple McGill pain questionnaire, Visual analogue grade (VAS), has no statistical significance (P0.05). 2. Evaluation of the curative effect of (VAS),: the total effective rate of the treatment group was 100 and the total effective rate of the control group was 90. The comparison between the two groups was statistically significant (P0.05). In the simple McGill pain questionnaire after 4-week treatment, the scores of emotion, sensation and visual analogue grade (VAS), were compared with the scores before treatment. There was statistical significance (P0.05), indicating that the two groups of treatment are effective. 4. After the first treatment, the pain improvement of VAS-PPI in the treatment group was better than that in the control group (P0.05), and there was no significant difference in the scores of affective indexes. 5. 1 week after treatment, the treatment group in sensory VAS pain improvement was better than the control group (P0.05), the other indicators were not statistically significant. 6. After the second week of treatment, the treatment group in the emotional category, sensory VAS pain relief effect was better than the control group (P0.05) PPI scores compared with no statistical difference. Four weeks after treatment, the two groups were statistically significant (P0.05), indicating that the treatment group after the 4th week treatment was better than the control group. 8. In the treatment group, 2 patients in the treatment group had slight swelling and pain on the second day after the first treatment, without any other discomfort. The symptoms could disappear after 2-3 days after the ice compress and proper recuperation, and the next treatment would not be affected. No significant adverse reactions were observed in other patients during treatment. Conclusion 1. Shock wave therapy combined with massage manipulation can effectively treat soft tissue injury of waist and hip. Shock wave therapy is more effective in the immediate and short term, less time consuming and less time consuming than computer medium frequency physiotherapy. Shock wave therapy combined with massage is an effective and effective method for the treatment of soft tissue injury of waist and hip, which is worth popularizing in clinic.
【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R685
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