【摘要】：研究目的:本研究采用臨床隨機對照研究方法,探討體外沖擊波療法結合推拿治療腰臀部軟組織損傷的治療效果,并評估該方法的臨床療效及安全性,為臨床治療腰臀部軟組織損傷患者尋找一種無創、有效、安全兼顧的治療方法,并在臨床上推廣。研究方法:將符合納入標準及排除標準的腰臀部軟組織損傷患者40例,按照臨床就診先后順序隨機分為治療組和對照組,每組各20例。2組患者均在推拿治療基礎上,治療組采用沖擊波治療,每5天治療1次,每次10-20分鐘,共治療4周6次;對照組予以電腦中頻理療療法,每周治療3次,隔天1次,每次治療20分鐘,共治療4周12次。兩組均以局部壓痛點和肌緊張帶為治療位置。分別于治療前、第一次治療后、第1周、第2周、第4周五個時間點觀察評分,以簡式McGill疼痛問卷中的情感類、感覺類、視覺模擬定級(VAS)、現在疼痛狀況(PPI)四項指標評估患者病情變化。并在治療過程中注意觀察患者是否有不良反應,如皮膚瘀斑、皮下血腫、心悸等。研究治療結束后把所有數據資料輸入SPSS22.0統計軟件進行統計數據分析,計量資料采用t檢驗;計數資料采用卡方檢驗或秩和檢驗。以P0.05為差異有統計學意義。研究結果:1.本研究納入的40例患者,治療期間無脫落或剔除,共完成40例。兩組患者治療前的一般資料(性別、年齡、病程)、簡式McGill疼痛問卷中情感類、感覺類、視覺模擬定級(VAS)、現在疼痛狀況(PPI)四項指標評分均無統計學意義(P0.05),兩組具有可比性。2.VAS療效評估方面:治療組總有效率100%,對照組總有效率90%,兩組的比較具有統計學意義(P0.05)。3.兩組4周治療結束后簡式McGill疼痛問卷中情感類、感覺類、視覺模擬定級(VAS)、現在疼痛狀況(PPI)四項指標評分與各組治療前評分進行比較,均有下降,具有統計學意義(P0.05),說明兩組治療均有效。4.第1次治療后,治療組在感覺類、VAS、PPI項疼痛改善情況優于對照組(P0.05),情感類指標評分比較無統計學意義。5.第1周治療后,治療組在感覺類、VAS項疼痛改善方面要優于對照組(P0.05);其余指標差異無統計學意義。6.第2周治療后,治療組在情感類、感覺類、VAS項疼痛緩解療效方面要優于對照組(P0.05);PPI指標評分比較無統計學差異。.7.第4周治療后,兩組各項指標評分比較均具有統計學意義(P0.05),說明第4周治療后治療組療效要優于對照組。8.治療過程中治療組有2例患者第1次治療后第2天出現治療部位稍腫痛現象,無其他不適,予以冰敷和適當休養后經2-3天后癥狀可消失,并且不影響下一次的治療,其余患者在治療期間均未出現明顯不良反應。結論:1.沖擊波療法結合推拿手法能夠有效治療腰臀部軟組織損傷。2.與電腦中頻理療療法相比,沖擊波療法的即時和近期療效更好,治療次數少,耗時更少。3.沖擊波療法聯合推拿是治療腰臀部軟組織損傷的一種起效快、臨床有效的治療方法,值得在臨床上推廣應用。
[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.
【學位授予單位】：廣州醫科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R685

【參考文獻】

相關期刊論文 前10條

1 梁宏;郭建文;王海平;張亮;沈素花;范曉敏;牛兵;趙陽;;觀察低濃度醫用臭氧局部注射治療軟組織損傷疼痛的臨床效果[J];世界最新醫學信息文摘;2016年75期

2 唐達信;;小針刀治療慢性軟組織損傷的療效觀察[J];北方藥學;2016年09期

3 董澤順;蔣武平;陳妙娟;;小針刀療法治療急性嚴重閉合性軟組織損傷臨床觀察[J];新中醫;2016年01期

4 李中偉;李昭龍;李偉;;推拿配合艾灸治療慢性腰肌勞損患者的療效觀察[J];中國臨床保健雜志;2015年02期

5 Mendell LM;劉婷婷;;疼痛閘門控制學說的構建與解構[J];中國疼痛醫學雜志;2014年10期

6 陳浩飛;田蜜;高獻忠;金毅;李偉彥;;電磁式沖擊波與神經阻滯治療肩周炎療效比較[J];中國醫學裝備;2014年S1期

7 董忠峰;;推拿與針灸治療腰部急慢性軟組織損傷36例[J];陜西中醫;2014年08期

8 ;骨肌疾病體外沖擊波療法專家共識[J];中國醫學前沿雜志(電子版);2014年06期

9 張浩沖;邢更彥;;沖擊波在醫學中的應用進展[J];中國醫學前沿雜志(電子版);2014年01期

10 張惠忠;張錦平;肖年生;;小針刀治療慢性軟組織損傷的臨床應用[J];中國實用醫藥;2014年02期

，

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