冲击波治疗肩周炎的诊断与治疗

I. Kola, Sander Kola, D. Mata, Esmeralda Novruzaj, Rea Sherifi
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摘要

简介:粘连性肩关节囊炎是一种引起关节疼痛和不活动的关节病变。在大多数情况下,原因是未知的。保守治疗效果良好但尚不明确,ESWT是一种辅助有效的治疗方法。目的:分析冲击波疗法(ESWT)治疗肩周炎和疼痛的疗效。方法:我们基于从医学网站(PubMed,Medline, WebMD, MedScope)上获取的7项研究。所有参考研究中诊断为粘连性囊炎的患者随机分为两组。在研究[1]中,体外冲击波治疗改善肩关节粘连性囊炎的短期功能结局[3],体外冲击波治疗改善糖尿病肩关节粘连性囊炎的功能结局研究[2]中,一组采用ESWT治疗,另一组采用口服AINS治疗。桡骨体外冲击波治疗肩关节粘连性囊炎的疗效:一项前瞻性、随机、双盲、安慰剂对照的临床研究,一组采用ESWT治疗,另一组采用安慰剂治疗。在研究[4]中,体外冲击波治疗对肩周炎患者疼痛和功能的影响。所有患者每天接受一次非甾体抗炎药治疗。本研究将受试者分为保守物理治疗组,其中一组采用ESWT治疗,所有受试者每周治疗2次,持续6周。在VAS和PSFS的组内比较中,ESWT组和CPT组的VAS和PSFS均显著降低。在VAS组和PSFS组的比较中,ESWTG的结果比CPTG低得多。在研究[6]《体外冲击波治疗肩周炎的疗效》和研究[7]《冲击波治疗和超声治疗加运动治疗肩周炎患者》中,一组采用ESWT治疗,另一组采用保守的物理治疗。结果:研究发现:与其他治疗相比,采用ESWT治疗的患者在疼痛和功能、关节ROM方面的改善更早、更明显,如:(安慰剂、AINS、保守治疗、超声)应用于患者。结论:综合以上研究,ESWT在治疗粘连性囊炎患者组的疼痛和功能、关节ROM方面比其他治疗方法更有效。
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Diagnosis and treatment of frozen shoulder with shock-wave therapy
Introduction: Adhesive capsulitis is pathology of the gleno-humeral joint that causes joint pain and immobility. The cause in most cases is unknown. Conservative treatment is good but still unclear, ESWT is an adjunctive and effective therapy for treatment. Objectives: To analyze the effectiveness of Shock-Wave therapy (ESWT) in the treatment of pain and ROM in frozen shoulder. Method: We based on 7 studies, taken from medical websites (PubMed,Medline, WebMD, MedScope). Patients diagnosed with adhesive capsulitis in all studies taken in reference were randomly divided into two groups. In studies [1], Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis and [3], Extracorporeal Shockwave Therapy Improves Functional Outcomes of Adhesive Capsulitis of the Shoulder in Patients With Diabetes one group was treated with ESWT, the other with oral AINS In studies [2]. The efficacy of radial extracorporeal shockwave therapy in shoulder adhesive capsulitis: a prospective, randomised, double-blind, placebo-controlled, clinical study one group was treated with ESWT, and the other with placebo treatment. In study [4], the effects of extracorporeal shock wave therapy on frozen shoulder patients’ pain and functions. All patients received NSAIDs once a day. The subjects of this study were divided into the conservative physical therapy group one group was treated with ESWT, All subjects were treated 2 times a week for 6 weeks. In within-group comparisons of VAS and PSFS, both ESWT and CPT groups showed significant decreases in VAS and PSFS. In comparisons between VAS and PSFS groups, ESWTG showed much lower results compared to CPTG. In studies [6], Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder and [7] Shock Wave Therapy and Ultrasound Therapy plus Exercises for Frozen Shoulder Joint Clients, one group was treated with ESWT, the other with conservative physical therapy Results: For the studies considered it was observed that: patients treated with ESWT have an earlier and more noticeable improvement in pain and functionality, articular ROM compared to the effect from other treatments such as: (placebo, AINS, conservative treatment, ultrasound) applied to patients. Conclusions: Based on the above studies, it is concluded that ESWT is more effective in treating pain and functionality, articular ROM, compared to other treatments applied to the groups of patients diagnosed with adhesive capsulitis.
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