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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 406 -411. doi: 10.3877/cma.j.issn.1674-134X.2022.04.004

临床论著

发散式与聚焦式冲击波治疗肩周炎合并糖尿病的疗效比较
王素凯1, 邵季超1, 仲亮2, 李静1, 李军勇1, 宁翠利3,()   
  1. 1. 050000 石家庄市第二医院运动医学科
    2. 050000 石家庄,河北省糖尿病精准医学重点实验室
    3. 050000 石家庄市第二医院内分泌科
  • 收稿日期:2021-06-26 出版日期:2022-08-01
  • 通信作者: 宁翠利
  • 基金资助:
    河北省科技支撑计划项目项目(172777212); 河北省医学科学研究课题计划项目(20210179); 河北省重点研发计划项目(19277739D)

Effects comparison of divergent and focused shock waves in treatment of shoulder periarthritis combined with diabetes mellitus

Sukai Wang1, Jichao Shao1, Liang Zhong2, Jing Li1, Junyong Li1, Cuili Ning3,()   

  1. 1. Department of Sports Medicine, The Shijiazhuang Second Hospital, Shijiazhuang 050000, China
    2. Hebei Provincial Key Laboratory of Basic Medicine for Diabetes, The Shijiazhuang Second Hospital, Shijiazhuang 050000, China
    3. Endocrinology Department, The Shijiazhuang Second Hospital, Shijiazhuang 050000, China
  • Received:2021-06-26 Published:2022-08-01
  • Corresponding author: Cuili Ning
引用本文:

王素凯, 邵季超, 仲亮, 李静, 李军勇, 宁翠利. 发散式与聚焦式冲击波治疗肩周炎合并糖尿病的疗效比较[J/OL]. 中华关节外科杂志(电子版), 2022, 16(04): 406-411.

Sukai Wang, Jichao Shao, Liang Zhong, Jing Li, Junyong Li, Cuili Ning. Effects comparison of divergent and focused shock waves in treatment of shoulder periarthritis combined with diabetes mellitus[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(04): 406-411.

目的

比较发散式冲击波与聚焦式冲击波结合康复锻炼治疗糖尿病患者的肩周炎的临床疗效。

方法

前瞻性收集2018年7月至2019年11月于石家庄市第二医院骨科门诊就诊的糖尿病合并肩周炎的患者62例。所有患者具有2年以上的糖尿病史且主要症状包括肩关节周围疼痛及肩部活动障碍,排除其他疾病引起的肩部疼痛。随机数字表法将其分为发散式冲击波治疗组和聚焦式冲击波治疗组两组,发散组采用发散式冲击波结合康复锻炼治疗31例,聚焦组采用聚焦式冲击波结合康复锻炼治疗31例。于治疗前和治疗后1、3 、6 、12个月随访并临床评价,评价指标包括疼痛视觉模拟评分(VAS)、肩关节功能Constant-Murley(CM)评分和前屈、外展、后伸、外旋等肩关节主动活动范围(AROM)。治疗前两组间的比较采用独立样本t检验。VAS评分、CM评分以及AROM的总体差异分析采用重复测量设计的单变量方差分析,并经Mauchly球形度检验。

结果

发散式冲击波治疗后1、3、6和12个月的肩关节疼痛VAS评分(F=3.03),肩关节AROM(前屈:F=7.22、后伸:F=15.85、外展:F=6.64、外旋:F=11.31)和Constant-Murley评分(F=3.26)均优于聚焦式冲击波,差异均有统计学意义(均为P<0.05)。

结论

相对于聚焦式冲击波结合康复锻炼,发散式冲击波结合康复锻炼治疗糖尿病合并肩周炎具有更好的疗效,安全可靠。

Objective

To evaluate the clinical efficiency of divergent shock wave and focused shock wave combined with rehabilitation exercise in the treatment of shoulder periarthritis in diabetes mellitus patients.

Methods

A total of 62 patients with diabetes mellitus complicated by periarthritis of shoulder who were treated in the Shijiazhuang Second Hospital from July, 2018 to November, 2019 were enrolled in the study. All the patients had a history of diabetes for more than two years, and the main symptoms included pain around the shoulder and shoulder movement disorders. The patients with shoulder pain caused by other diseases were exclude. The patients were divided into two gourps by random number table, 31 in each. One group were treated by divergent shock wave, the other group were treated by focused shock wave. After treatment the patients in both groups were followed up for 12 months. The pain, the range of motion, the status of shoulder joint function were evaluated according to the visual analogue scale(VAS)score of shoulder joint pain, the range of motion of shoulder joint (flexion, abduction, extension, external rotation) and Constant-Murley(CM) score before treatment, at one, three, six, and 12 months after the treatment. The parameters of the two groups were compared by Student t test. Overall differences in VAS score of shoulder joint pain, the range of motion of shoulder joint (flexion, abduction, extension, external rotation) and CM score were analyzed by variance for repeated measurement data, and the data were tested by Mauchly test of sphelicity.

Results

In one, three, six and 12 months after the treatment with divergent shock wave, the VAS score of shoulder pain(F=3.03), the range of motion of shoulder (flexion: F=7.22, abduction: F=15.85, extension: F=6.64, external rotation: F=11.31), and CM score(F=3.26)were better than that of focused shock wave, and the difference was statistically significant (all P <0.05).

Conclusion

Compared with focused shock wave combined with rehabilitation exercise, divergent shock wave combined with rehabilitation exercise has better curative effect and is safe and reliable.

表1 两组患者治疗前的一般临床资料比较
表2 两组VAS和CM评分不同时间点比较(±s)
表3 两组肩关节AROM不同时间点比较[°,(±s)]
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