淮南联合大学, 安徽淮南 232000
摘要:体外冲击波作为一种新兴的康复治疗手段,通过机械压力效应和空化效益等减轻软组织的粘连和挛缩,减少炎性因子的分泌,促进血液运输,从而改善慢性下腰痛的主要症状疼痛和运动受限。本文通过系统回顾相关文献,对体外冲击波治疗慢性下腰痛的临床疗效、作用机制以及应用剂量进行综述,以期为该技术临床应用提供理论依据。
关键词:慢性下腰痛;体外冲击波
参考文献;
[1]Balagué F, Mannion AF, Pellisé F, Cedrasc hi C. Nonspecific low back pain. Lancet 2012;3 79:482-91.
[2] Clark S, Horton R. Low back pain: a major global challenge. Lancet. 2018;391(10137):230 2.
[3] Wu A, March L, Zheng X, Huang J, Wang X, Z hao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years liv ed with disability from 1990 to 2017: estimate s from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299.
[4] Katz JN. Lumbar disc disorders and low-bac k pain: socioeconomic factorand consequences. J Bone Joint Surg Am. 2006;88(Suppl 2):21–4.
[5] Goubert D, Oosterwijck JV, Meeus M, Dannee ls L. Structural changes of lumbar muscles in non-specifc low back pain: a systematic review. Pain Phys. 2016;19(7):E985–1000.
[6] Purushotham S, Stephenson RS, Sanderson A, Abichandani D, Greig C, Gardner A, Falla D. M icroscopic changes in the spinal extensor musc ulature in people with chronic spinal pain: a systematic review. Spine J. 2022;22(7):1205–2 1.
[7] Maher C,Underwood M,Buchbinder R. Nonspe cific low back pain[J].Lancet,2017,389(10 07 0):736—747.
[8]Kreiner DS, Matz P, Bono CM, Cho CH, Easa J E, Ghiselli G, Ghogawala Z, Reitman CA, Resnic k DK, Watters WR, et al. Guideline summary rev iew: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020;20(7):998–1024。
[9] Dizon, J.N.C.; Gonzalez-Suarez, C.; Zamora, M.T.G.; Gambito, E.D. Effectiveness of extrac orporeal shock wave therapy in chronic plantar fasciitis: A meta-analysis. Am. J. Phys. Med. Rehabil. 2013, 92, 606–620.
[10] Simplicio, C.L.; Purita, J.; Murrell, W.; Santos, G.S.; Dos Santos, R.G.; Lana, J.F.S.D. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J. C lin. Orthop. Trauma 2020, 11 (Suppl. 3),309–3 18.
[11] Mariotto S, de Prati AC, Cavalieri E, Ame lio E, Marlinghaus E, Suzuki H. Extracorporeal shock wave therapy in inflammatory diseases: Molecular mechanism that triggers anti-inflamm atory action. Curr Med Chem 2009;16:2366-72.
[12] Lee S, Lee D, Park J. Effects of extracor poreal shockwave therapy on patients with chr onic low back pain and their dynamic balance a bility. J Phys Ther Sci 2014;26:7-10.
[13] Stania, M.; Juras, G.; Chmielewska, D.; P olak, A.; Kucio, C.; Król, P. Extracorporeal Shock Wave Therapy for Achilles Tendinopathy. BioMed Res. Int. 2019, 2019, 3086910.
[14] Chao, Y.-H.; Tsuang, Y.-H.; Sun, J.-S.; C hen, L.-T.; Chiang, Y.-F.; Wang, C.-C.; Chen, M.-H. Effects of shock waves on tenocyte proli feration and extracellular matrix metabolism.2024 年 1 卷 3 期 聚知刊出版社 医学研究 JZK publishing 62 Ultrasound Med. Biol. 2008, 34, 841–852
[15] Wang, C.J. Extracorporeal shockwave thera py in musculoskeletal disorders. J. Orthop. Su rg. Res. 2012, 7, 11
[16] Cui, H.S.; Joo, S.Y.; Cho, Y.S.; Park, J. H.; Ro, Y.M.; Kim, J.-B.; Seo, C.H. Effect of extracorporeal shock wave therapy on keratinoc ytes derived from human hypertrophic scars. Sc i. Rep. 2021, 11, 17296.
[17] 孙宁,张通,叶婷,等. 体外冲击波对脑卒中患者 手部肌张力增高的疗效观察 [J]. 神经损伤与功能重 建, 2024, 19 (02): 121-124.
[18] 李郭茜,朱志春,龙铁军,等. 体外冲击波联合核 心稳定性训练对产后骶髂关节疼痛的临床研究 [J]. 中国康复, 2024, 39 (02): 94-98.
[19] 金星,余德标,黄凯,等. 经筋辨证结合体外冲击 波疗法治疗腰椎间盘突出症的效果观察 [J]. 中国医 学创新, 2024, 21 (02): 84-87.
[20] Stania, M.; Król, B.; Franek, A.; B?aszcz ak, E.; Dolibog, P.; Polak, A.; Dolibog, P.; D urma?a, J.; Król, P. A comparative study of th e effificacy of radial and focused shock wave therapy for tennis elbow depending on symptom duration. Arch. Med. Sci. 2020, 17, 1686–169 5.
[21] Lizis, P. Analgesic effect of extracorpor eal shock wave therapy versus ultrasound thera py in chronic tennis elbow. J. Phys. Ther. Sci. 2015, 27, 2563–2567.
[22] Haake, M.; K?nig, I.R.; Decker, T.; Riede l, C.; Buch, M.; Müller, H.-H.; Extracorporea l Shock Wave Therapy Clinical Trial Group. Ext racorporeal shock wave therapy in the treatmen t of lateral epicondylitis: A randomized multi center trial. J. Bone Jt. Surg. Am. 2002, 84, 1982–1991.
[23] Fricová J, Rokyta R. The effects of extr acorporeal shock wave therapy on pain patients. Neuro Endocrinol Lett 2015;36:161-4. [24] 郑志新,高谦,王军,等. 气动弹道式体外冲击波 治疗慢性非特异性下腰痛的效果 [J]. 中国康复理论 与实践, 2013, 19 (07): 666-668.
[25] 乔思竹,韦嵩,陈志煌,等. 体外冲击波治疗对慢 性非特异性下腰痛的临床疗效 [J]. 微循环学杂志, 2023, 33 (04): 56-59+63.
[26] Schroeder AN, Tenforde AS, Jelsing EJ. Ex tracorporeal shockwave therapy in the manageme nt of sports medicine injuries. Curr Sport Med Rep. 2021;20(6):298–305.
[27] Gerdesmeyer L, Wagenpfeil S, Haake M, Mai er M, Loew M, Wortler K, Lampe R, Seil R, Handle G, Gassel S, et al. Extracor poreal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuf: a randomized controlled trial. JAMA J Am Med Assoc. 2003;290(19):2573–80
[28] 刘宜军,杨勇,孙丽敏. 附子汤合芍药甘草汤加 味离子导入治疗寒湿瘀阻证非特异性下腰痛[J].中国 实验方剂学杂志,2017,23(20):195-200. [29] 蔡燕,周宗波,桂树虹,等.加味乌附麻辛桂姜汤 治疗慢性非特异性下腰痛寒湿瘀阻证的临床观察[J]. 中国实验方剂学杂志,2019,25(7):128-133. [30] 吴迪,王清,张殿文,等. 柴芩解热颗粒对发热大 鼠解热作用及血清TNF-ɑ、IL-1β、PGE_2、AVP表达水 平的影响 [J]. 北华大学学报(自然科学版), 2023, 24 (01): 53-57.
[31] Chen YT,Yang CC,Sun CK,et al. Extracorp oreal shock wave therapy ameliorates cyclophos phamide-induced rat acute interstitial cystiti s though inhibiting inflammation and oxidative stress-in vitro and in vivo experiment studie s [J]. Am J Transl Res,2014,6(6):631-648.
[32] Feng B. DongZ, Wang Y. et aL. Li-ESWT tre atment reduces inflammation, oxidative stres, and pain via the PI3K/AKT/FOXO1 pathway in aut oimmune prostatitis rat models[J]. Anrdrology, 2021,9(5): 1 593-1 602.
[33] Schleusser S,Song J,Stang FH,et al. Blo od Flow in the Scaphoid Is Improved by Focused Extracorporeal Shock Wave Therapy [J]. Clin O rthop Relat Res,2020,478(1):127-135.
[34] Han H,Lee D,Lee S,et al. The effects of e xtracorporeal shock wave therapy on pain,disab ility,and depression of chronic low back pain patients [J]. J Phys Ther Sci,2015,27(2):397-3 99.
[35] Delius M,Draenert K,Al Diek Y, et al. Bio logical effeets of shock waves: in vivo effect of high energy pulses on rabbit bone[J]. Ultr asound Med Biol, 1995, 21(9): 1219- 1225.
[36] 李富林,黄宇,尹东, 等. 体外冲击波治疗肱骨 外上髁炎的效果评价: 一项短 -中期随访[J].实用医 学杂志, 2020,36. (24):3369-3372.
[37] 章璟, 徐冀东,杨佳伟,等. 不同焦斑与能量冲 击波碎石机治疗肾结石的疗效及对早期肾功能影响的 随机对照研究[J]. 实用医学杂志,2018, 34(5):77 4-777.
[38] 李富林,尹东,黄宇,等. 不同剂量体外冲击波治 疗肱骨外上髁炎的疗效对比 [J]. 广东医学, 2023, 44 (03): 374-378.
[39] 刘旸,贾云,翁浩,等. 不同剂量体外冲击波治疗 早中期膝骨关节炎近期疗效比较 [J]. 中国康复, 20 21, 36 (11): 665-668.