摘要
目的比较体外冲击波疗法(ESWT)和针刀疗法(NKT)在慢性跖筋膜炎(CPF)治疗中的临床疗效。方法选取南京医科大学金陵临床医学院骨科2021年6月—2022年6月收治的48例CPF患者作为研究对象。根据医患沟通结果和患者意向确定具体治疗方案,然后根据治疗方案将患者分为NKT组(26例)和ESWT组(22例)。ESWT组采用激痛点治疗模式,NKT组采用针刀松解治疗模式。分别于治疗前及治疗后1周、1个月、3个月和6个月时,应用视觉模拟评分法(VAS)评定2组患者足跟静息痛和活动痛程度,应用压痛评分评定足跟压痛程度。结果整体分析发现:2组患者治疗前后足跟静息痛、活动痛和足跟压痛的组间比较及各时间点比较,差异均具有统计学意义(P<0.05)。组内比较:治疗后各随访时间节点,2组患者的足跟静息痛、活动痛和足跟压痛均较治疗前明显改善(P<0.05);2组患者治疗后1个月、3个月和6个月的足跟静息痛、活动痛和足跟压痛程度均低于治疗后1周(P<0.05);2组患者治疗后3个月和6个月的足跟压痛与治疗后1个月相比,差异均无统计学意义(P>0.05);NKT组患者治疗后3个月和6个月的足跟静息痛和活动痛均较治疗后1个月明显改善(P<0.05);ESWT组患者治疗6个月后的足跟静息痛和活动痛程度均较治疗后1个月和3个月增加(P<0.05)。组间比较:治疗后1个月、3个月和6个月时,NKT组患者的足跟静息痛、活动痛和足跟压痛程度均明显低于ESWT组(P<0.05),且随着随访时间延长,2组患者之间的足跟静息痛和活动痛VAS评分差异逐渐增大,但足跟压痛评分间的差异变化不大。结论ESWT和NKT均能有效缓解CPF患者的足跟静息痛、活动痛和足跟压痛,并具有较好的镇痛维持效果,但NKT的中远期镇痛效果和维持效果更佳。
Objective To compare the therapeutic effects of extracorporeal shock wave therapy(ESWT)and needle-knife therapy(NKT)in the treatment of chronic plantar fasciitis(CPF).Methods Forty-eight CPF patients admitted to the De-partment of Orthopedics,Jinling Clinical Medical College,Nanjing Medical University from June 2021 to June 2022 were se-lected as the study participants.The specific treatment plan was determined based on the results of doctor-patient communi-cation and patient preferences,and the patients were allocated to the NKT group(n=26)and the ESWT group(n=22)following the treatment plan.The ESWT group received treatment using the painful point treatment mode;while the NKT group,treatment using the needle-knife loosening treatment mode.The visual analog scale(VAS)was used to assess the severity of heel resting pain and activity pain in both groups before treatment and at 1 week,1 month,3 months,and 6 months after treatment.The tenderness score was adopted to assess the degree of heel tenderness.Results Overall analysis revealed statistically significant differences in the comparison between the two groups and at each time point before and after treatment for heel resting pain,activity pain,and heel tenderness(P<0.05).Within-group comparisons showed that at each follow-up time point after treatment,heel resting pain,activity pain,and heel tenderness were significantly improved compared to before treatment in both groups(P<0.05).The heel resting pain,activity pain,and heel tenderness at 1 month,3 months,and 6 months after treatment were significantly lower than those at 1 week after treatment in both groups(P<0.05).No statistically significant difference was observed in heel tenderness between 3 months and 6 months after treatment compared to 1 month after treatment in both groups(P>0.05).The heel resting pain and activity pain at 3 months and 6 months after treatment were significantly improved compared to 1 month after treatment in the NKT group,while the heel resting pain and activity pain at 6 months after
作者
黄伟谦
冷楠楠
王永强
柏天婷
陈建民
刘国印
Huang Weiqian;Leng Nannan;Wang Yongqiang;Bai Tianting;Chen Jianmin;Liu Guoyin(Department of Orthopedics,Jinling Clinical Medical College,Nanjing Medical University/General Hospital of Eastern Theater Command of the People's Liberation Army,Nanjing 210000,China;Department of Rehabilitation,Jinling Clinical Medical College,Nanjing Medical University/General Hospital of Eastern Theater Command of the People's Liberation Army,Nanjing 210000,China)
出处
《保健医学研究与实践》
2024年第1期65-72,共8页
Health Medicine Research and Practice
基金
国家自然科学基金青年科学基金项目(82102547)
江苏省自然科学基金面上项目(BK20181113)。
关键词
针刀疗法
体外冲击波疗法
慢性跖筋膜炎
静息痛
活动痛
足跟压痛
Needle-knife therapy
Extracorporeal shock wave therapy
Chronic plantar fasciitis
Resting pain
Activity pain
Heel tenderness
