不同能流密度下中等能量发散式冲击波治疗跖筋膜炎的短期疗效分析

关键词：跖筋膜炎  冲击波  能流密度

Keywords:plantar fasciitis  shock wave  energy flux density

摘要：

      摘要 目的：分析不同能流密度下中等能量发散式冲击波对跖筋膜炎的短期影响。 方法：回顾性分析2017年1月—2021年10月经中等能量发散式冲击波治疗的213例跖筋膜炎患者的临床资料，按0.12mJ/mm2治疗者73例（A组）；0.14 mJ/mm2治疗者71例（B组）；0.16 mJ/mm2治疗者69例（C组）。评价指标为治疗后第4周疼痛视觉模拟评分（visual analogue scale， VAS）及美国矫形外科足踝协会（American Orthopedic Foot and Ankle Society Score， AOFAS）踝—后足功能评分较治疗前的变化；通过治疗前后AOFAS评分差值评价组间疗效差异。建立回归模型探究疗效优良的相关因素。 结果：三组在性别、年龄、单双侧、患病时间及BMI无显著性差异，所有患者治疗后无不良反应。三组患者的VAS和AOFAS评分治疗前后均有显著改善（P<0.001）；组间AOFAS评分的差值有显著性差异（P<0.05）。逻辑回归表明：年龄（OR=0.946，P<0.05）和患足的单双侧（OR=0.102，P<0.05）可能是影响疗效的危险因素。 结论：中等能量发散式冲击波治疗跖筋膜炎能在短期内取得较好疗效，但能流密度（0.12—0.16mJ/mm2）可能不是决定疗效的关键因素。

Abstract:

      Abstract Objective： To analyze the short-term effects of medium-intensity radial shock wave therapy on plantar fasciitis at different energy flux densities. Method： A retrospective analysis was performed on the clinical data of 213 patients with plantar fasciitis treated with medium-intensity radial shockwaves from January 2017 to October 2021: 73 cases were divided in 0.12mJ/mm2（A group）；71 cases in 0.14mJ/mm2（B group）；and 69 cases in 0.16mJ/mm2（C group）. The evaluation index were changes in the visual analogue scale（VAS） and the-hindfoot function score of the American Orthopedic Foot and Ankle Society Score（AOFAS） in the 4th week post-treatment compared to pre-treatment. The difference in efficacy between groups was evaluated by the difference between groups before and after treatment with AOFAS score. A regression model was established to explore the relevant factors of good therapeutic outcomes. Result： There were no significant statistical differences in gender， age，unilateral or bilateral condition， duration of illness and BMI among the three groups. All patients had no adverse effects after treatment. The VAS and AOFAS scores in all the three groups improved significantly before and after treatment （P<0.001）. There was a statistically significant difference in AOFAS scores between groups （P<0.05）. Logistic regression showed that age （OR=0.946， P<0.05）， unilateral and bilateral sides of the affected foot （OR=0.102， P<0.05） may be risk factors affecting the therapeutic outcome. Conclusion： Medium-intensity radial shock wave therapy can achieve good short-term efficacy in treating planter fasciitis. However， the energy flow density （0.12—0.16 mJ/mm2） may not be a key factor in determining the therapeutic outcome.