电子聚焦式高能体外冲击波联合常规口服药物治疗强直性脊柱炎
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作者Author单位AddressE-Mail
张万义 ZHANG Wan-yi 洛阳正骨医院 河南省骨科医院, 河南 洛阳 471002 Luoyang Osteopathic-Traumatological Hospital, Luoyang 471002, Henan, China  
陈献韬 CHEN Xian-tao 洛阳正骨医院 河南省骨科医院, 河南 洛阳 471002 Luoyang Osteopathic-Traumatological Hospital, Luoyang 471002, Henan, China luoyangzhenggu@163.com 
王笑青 WANG Xiao-qing 洛阳正骨医院 河南省骨科医院, 河南 洛阳 471002 Luoyang Osteopathic-Traumatological Hospital, Luoyang 471002, Henan, China  
张蕾蕾 ZHANG Lei-lei 洛阳正骨医院 河南省骨科医院, 河南 洛阳 471002 Luoyang Osteopathic-Traumatological Hospital, Luoyang 471002, Henan, China  
罗姣 LUO Jiao 洛阳正骨医院 河南省骨科医院, 河南 洛阳 471002 Luoyang Osteopathic-Traumatological Hospital, Luoyang 471002, Henan, China  
期刊信息:《中国骨伤》2021年,第34卷,第11期,第1020-1024页
DOI:10.12200/j.issn.1003-0034.2021.11.007
基金项目:
中文摘要:

目的:探讨体外冲击波联合常规口服药物治疗强直性脊柱炎患者疾病活动度及骶髂关节影像学进展,寻找一种新的安全有效的治疗方法。

方法:对2018年1月至2018年12月收治的30例强直性脊柱炎患者进行回顾性分析,其中男20例,女10例,年龄18~50(34.50±9.60)岁。30例患者治疗前MRI上均伴有不同程度的骶髂关节骨髓水肿情况。30例患者根据治疗方法的不同分为治疗组和对照组,其中对照组15例,采用非甾体抗炎药和柳氮磺吡啶肠溶片治疗;治疗组15例,在对照组基础上加电子聚焦式高能体外冲击波。对两组患者的病程、年龄及治疗前后血沉、C-反应蛋白进行分析,并采用疼痛视觉模拟评分(visual analogue scale,VAS),加拿大脊柱骨关节研究协会(spondyloarthritis research consortium Canada,SPARCC)评分系统分别评估骶髂关节疼痛及骶髂关节结构损伤情况,同时计算Bath强直性脊柱炎疾病活动指数(Bath ankylosing spondylitis disease activity index,BASDAI)。

结果:所有病例获得3个月以上随访。(1)治疗1个月后VAS、SPARCC评分治疗组明显优于对照组(P<0.05)。(2)治疗1个月后,BASDAI、血沉、C-反应蛋白两组差异无统计学意义(P>0.05)。(3)所有患者治疗后的VAS、BASDAI、SPARCC评分及血沉、C-反应蛋白较治疗前明显改善(P<0.01)。

结论:电子聚焦式高能体外冲击波联合常规药物治疗强直性脊柱炎在快速缓解疼痛、改善疾病活动度、阻止影像学进展方面具有较好的临床效果,并且安全性高、无创,值得临床推广应用。
【关键词】体外冲击波疗法  高能量冲击波  脊柱炎,强直性
 
Electronic focusing high-energy extracorporeal shockwave combined with conventional oral medicine for the treatment of ankylosing spondylitis
ABSTRACT  

Objective: To observe the progress of disease activity and sacroiliac joint imaging in patients with ankylosing spondylitis treated by extracorporeal shockwave combined with conventional oral medicine, and find a new safe and effective therapeutic method.

Methods: The clinical data of 30 patients with ankylosing spondylitis treated from January 2018 to December 2018 were retrospectively analyzed. Including 20 males and 10 females, aged from 18 to 50 years with an average of(34.50±9.60) years. All 30 patients had different degrees of sacroiliac joint bone marrow edema on MRI before treatment. Thirty patients were divided into treatment group and control group according to different treatment methods. Among them, 15 cases in control group were treated with non-steroidal anti-inflammatory drugs and sulfasalazine enteric-coated tablets, for the 15 cases in treatment group, in addition to oral medicine in line with control group, electronic focusing high-energy extracorporeal shockwave therapy was added. The course of disease, age, pre- and post-treatment erythrocyte sedimentation rate, C-reactive protein in the two groups were analyzed; and visual analogue scale (VAS) and spondyloarthritis research consortium Canada (SPARCC) scoring system were used to evaluate the pain of the sacroiliac joint and the structural damage of the sacroiliac joint;Bath ankylosing spondylitis disease activity index (BASDAI) was calculated.

Results: All patients were followed up for at least 3 months. One month after treatment, VAS, and SPARCC scores in treatment group were significantly better than in control group (P<0.05). After 1 month of treatment, there was no significant difference in BASDAI, erythrocyte sedimentation rate and C-reactive protein between two groups(P>0.05). VAS, BASDAI, SPARCC, erythrocyte sedimentation rate, and C-reactive protein of all patients after treatment were significantly improved compared with those before treatment (P<0.01).

Conclusion: Electronic focusing high-energy extracorporeal shockwave combined with conventional oral medicine in the treatment of ankylosing spondylitis has a good clinical effect in rapidly relieving pain, improving disease activity, and preventing imaging progress. In addition, it is safe and non-invasive, which is worthy of clinical application.
KEY WORDS  Extracorporeal shockwave therapy  High-energy shock waves  Spondylitis,ankylosing
 
引用本文,请按以下格式著录参考文献:
中文格式:张万义,陈献韬,王笑青,张蕾蕾,罗姣.电子聚焦式高能体外冲击波联合常规口服药物治疗强直性脊柱炎[J].中国骨伤,2021,34(11):1020~1024
英文格式:ZHANG Wan-yi,CHEN Xian-tao,WANG Xiao-qing,ZHANG Lei-lei,LUO Jiao.Electronic focusing high-energy extracorporeal shockwave combined with conventional oral medicine for the treatment of ankylosing spondylitis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(11):1020~1024
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