摘要
目的探讨脉冲射频联合体外冲击波治疗肩周炎的疗效。方法选取2017年4月至2020年4月肩周炎患者195例,随机分为3组,每组各65例,分别采用脉冲射频、体外冲击波以及两者联合治疗,比较3组治疗效果、疼痛、肩关节功能、疼痛介质、炎症因子水平。结果治疗后,联合治疗组治疗总有效率为95.2%,高于脉冲射频组80.0%与体外冲击波组83.6%(P<0.05)。治疗后1周、1个月、3个月、6个月3组疼痛数字评分法(NRS)评分依次降低,且联合治疗组NRS评分低于同期脉冲射频组与体外冲击波组(P<0.05)。Constant-Murley肩功能(CM)评分依次升高,且联合治疗组CM评分高于同期脉冲射频组与体外冲击波组(P<0.05)。治疗后1周、1个月、3个月、6个月3组疼痛介质5-HT、P物质(SP)水平依次降低,且联合治疗组5-HT、SP水平低于同期脉冲射频组与体外冲击波组(P<0.05)。IL-6、TNF-α水平依次降低,IL-10水平依次升高,且联合治疗组IL-6、TNF-α水平低于同期脉冲射频组与体外冲击波组,IL-10水平高于同期脉冲射频组与体外冲击波组(P<0.05)。治疗后6个月联合治疗组SF-36各项评分高于脉冲射频组与体外冲击波组(P<0.05)。结论脉冲射频联合体外冲击波治疗肩周炎具有更好的治疗效果,能减轻炎症和疼痛,改善肩功能水平。
Objective To discuss the effect of pulsed radiofrequency(PRF)combined with extracorporeal shock wave(ESW)for scapulohumeral periarthritis on shoulder function,pain,serum tumor necrosis factorα(TNF-α)and interleukin-6(IL-6).Methods A total of 195 patients with scapulohumeral periarthritis,who were admitted to authors’hospital to receive treatment between April 2017 and April 2020,were enrolled in this study.The patients were randomly and equally divided into PRF group(treated with PRF,n=65),ESW group(treated with ESW,n=65)and combination group(treated with PRF+ESW,n=65).The curative effect,pain,shoulder function,pain mediators and the levels of inflammatory factors were compared between each other among the three groups.Results After treatment,the total effectiveness of treatment in combination group was 95.2%,which was obviously higher than 80.0%in PRF group as well as higher than 83.6%in ESW group(P<0.05).The postoperative one-week,one-month,3-month and 6-month pain scores measured by numeric rating scale(NRS)were gradually decreased in all three groups,but the NRS score measured at each time-point in combination group was remarkably lower than that in PRF group and in ESW group(P<0.05).The postoperative one-week,one-month,3-month and 6-month Constant-Murley(CM)shoulder function scores were gradually increased in all three groups,but the CM score determined at each time-point in combination group was higher than that in PRF group and in ESW group(P<0.05).The postoperative one-week,one-month,3-month and 6-month 5-hydroxy tryptamine(5-HT)levels and substance P(SP)levels were gradually decreased in all three groups,but both the 5-HT level and SP level measured at each time-point in combination group were lower than those in PRF group and in ESW group(P<0.05).The postoperative one-week,one-month,3-month and6-month IL-6 levels and TNF-αlevels were gradually decreased while IL-10 levels were gradually increased in all three groups,but both the IL-6 level and TNF-αlevel measured at each time-point in combination group were lower than those in PRF group and in ESW group,while the IL-10 level measured at each time-point in combination group was higher than that in PRF group and in ESW group(P<0.05).Six months after treatment,each indicator score of SF-36 quality of life scale in combination group was higher than that in PRF group and in ESW group(P<0.05).Conclusion For the treatment of scapulohumeral periarthritis,PRF together with ESW has much better curative effect,it can alleviate inflammation and pain,and improve shoulder function as well.
作者
徐晖
王春满
王璐璐
李琳
高谦
XU Hui;WANG Chunman;WANG LuLu;LI Lin;GAO Qian(Department of Pain Treatment,Hengshui Municipal People’s Hospital,Hengshui,Hebei Province 053000,China)
出处
《介入放射学杂志》
CSCD
北大核心
2022年第2期148-153,共6页
Journal of Interventional Radiology
关键词
脉冲射频
冲击波
肩周炎
疼痛
炎症
pulsed radiofrequency
shock wave
scapulohumeral periarthritis
pain
inflammation
