发散式冲击波联合雷火灸疗法治疗肌腱末端病33例临床疗效观察

张建东　李亚平　李毓军

[摘要] 目的 研究发散式冲击波联合雷火灸疗法在肌腱末端病的临床应用价值。 方法 对我科门诊收治的66例肌腱末端病患者，随机分为两组，分别采用发散式冲击波联合雷火灸治疗33例，中频联合雷火灸治疗33例，将治疗效果和康复情况用疼痛和相关关节功能评分数据进行统计学分析。分别在治疗开始后1周、1个月、3个月、6个月进行随访。 结果 采用秩和检验统计学分析，治疗开始后按疼痛评分，治疗组总有效率90.9%，对照组63.6%；按关节功能评分，治疗组平均总优良率87.9%，对照组60.6%；两组治疗效果有统计学意义（P<0.05）。 结论 采用发散式冲击波联合雷火灸疗法治疗肌腱末端病操作简单，并发症低，可使痛点明显缓解，关节功能恢复良好。

[关键词] 发散式冲击波；雷火灸；肌腱末端病

[中图分类号] R246.9 [文献标识码] A [文章编号] 2095-0616（2017）15-60-04

[Abstract] Objective To study the divergent type blast joint thunder fire moxibustion therapy in the end of the tendon disease clinical application value. Methods 66 cases of patients with tendon end disease cured in our department outpatient tendons were randomly divided into two groups，they were treated with the divergent type shock waves with thunder fire moxibustion therapy 33 cases and intermediate frequency joint thunder fire moxibustion treatment of 33 cases separately.The treatment effect and recovery of pain and joint function score data were statistically analyzed.In 1 weeks，1 month，3 months，6 months after the start of treatment， they were followed up. Results Wilcoxon test was used to statistically analyze.According to pain score after treatment began，the total effectiveness of treatment group was 90.9%，the control group was 63.6%.According to the joint function score，the average total of treatment group was 87.9%，and the control group was 60.6%.The treatment effect of two groups had obvious difference （P<0.05）. Conclusion The divergent type shock waves combination thunder fire moxibustion therapy to treat tendon at the end of the operation is simple，complication is low.It can make pain relief，apparently joints function recovered well.

[Key words] Divergent type shock waves；Thunder fire moxibustion；Tendon terminal illness

肌腱末端病是指肌腱、韌带或关节囊附着骨的部位或在骨的附着点因慢性损伤发生的以局部血液障碍为主的变性或炎性病变[1]，以肱骨外上髁炎、肱二头肌长头腱鞘炎、跖筋膜炎、肩袖损伤、髌周炎、跳跃膝等最为常见，严重影响患者的工作、生活。传统的局部注射、理疗、针灸、小针刀、药物治疗等效果欠佳，易复发，手术治疗创伤大，术后有关节粘连、瘢痕挛缩等缺点。2015年11月～2016年10月笔者采用发散式冲击波联合雷火灸外贴对33例肌腱末端病患者进行治疗，通过和33例中频联合雷火灸治疗后的结果对比，证实该方法临床疗效满意，现报道如下。

1 资料与方法

1.1 一般资料

纳入研究的66例肌腱末端病患者，均为常见好发部位且排除骨性、神经性、代谢性、肿瘤性、感染性疾病，治疗前用视觉模拟评分法（visual analogue scale，VAS）[2]自评疼痛强度≥5分。……