| 体外冲击波治疗与局部封闭对急性跖筋膜炎的疗效对比研究 |
| Comparison of extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of acute plantar fasciitis |
| 投稿时间：2024-11-11 |
| DOI：10.3969/j.issn.1672-5972.2026.01.008 |
| 中文关键词: 跖筋膜炎 体外冲击波 封闭疗法 |
| 英文关键词:Plantar fasciitis Extracorporeal shock wave Corticosteroid injection |
| 基金项目: |
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| 中文摘要: |
| 目的 比较体外冲击波治疗（extracorporeal shock wave therapy, ESWT）与局部封闭（local corticosteroid injection, LCI）对急性跖筋膜炎（acute plantar fasciitis, APF）的临床疗效差异。方法 采集2019年1月至2022年7月北部战区总医院诊治的APF患者的临床资料。根据纳入与排除标准，纳入96例患者，将患者随机分为两组（每组48例），EWST组接受ESWT（0.16 mJ/mm2，每次冲击2 000次，隔日1次，共3次）；LCI组接受LCI（单次40 mg甲泼尼龙联合2 mL的2%利多卡因），治疗部位均为足跟内下方痛点处。比较两组治疗后3周、6周、3个月及1年改良足部功能指标（revised foot function index, FFI-R）和可视疼痛评分（visual analog scale, VAS）差异，记录两组治疗后3个月和1年时的有效率和复发率。结果 最终71例患者（EWST组37例、LCI组34例）均完成1年随访。两组各时间点FFI-R评分及VAS评分均较治疗前明显改善，差异有统计学意义（P＜0.05）；两组间不同时间点比较，LCI组的FFI-R评分及VAS评分均优于EWST组，差异有统计学意义（P＜0.05）。治疗后3个月和1年时，EWST组的有效率低于LCI组（54.1% vs 82.4%，χ2=4.722，P＜0.05；27.0% vs 58.8%，χ2=5.212，P＜0.05），EWST组的复发率高于LCI组（35.1% vs 17.6%，χ2=5.147，P＜0.05；70.3% vs 44.1%，χ2=3.638，P＜0.05），差异有统计学意义。结论 对于APF，ESWT和LCI均具有良好的临床疗效，但后者临床疗效更佳，复发率更低。 |
| 英文摘要: |
| Objective To compare the clinical outcomes of extracorporeal shockwave therapy (ESWT) and local corticosteroid injection (LCI) in the treatment of acute plantar fasciitis (APF).Methods Clinical data from APF patients treated at General Hospital of Northern Theater Command between January 2019 and July 2022 were analysed. According to the inclusion and exclusion criteria, 96 patients were included and randomly divided into an ESWT group (48 patients) and an LCI group (48 patients). The EWST group received ESWT (0.16 mJ/mm², 2 000 impulses, once every other day for 3 sessions at one-week intervals), while the LCI group received a single dose of 40 mg of methylprednisolone combined with 2 mL of 2% lidocaine. The injection was performed in the section of the plantar fascia with the greatest tenderness.Revised foot function index (FFI-R) and visual analogue scale (VAS) scores were assessed at 3, 6 and 12 weeks and 1 year after treatment. The effective and recurrence rates at 3 months and 1 year after treatment were also recorded and compared.Results Finally, 71 patients (37 in EWST group and 34 in LCI group) completed final follow-up. The FFI-R and VAS scores at different follow-up time point in both groups had significantly improved than those before treatment (P<0.05). The FFI-R and VAS scores in LCI group were better than those in EWST group at different follow-up time point (P<0.05). At 3 months and 1 year after treatment, the effective rate of EWST group was lower than that of LCI group (54.1% vs 82.4%, χ2=4.722, P<0.05; 27.0% vs 58.8%, χ2=5.212, P<0.05), and the recurrence rate of EWST group was higher than that of LCI group (35.1% vs 17.6%, χ2=5.147, P<0.05; 70.3% vs 44.1%, χ2=3.638, P<0.05).Conclusion For APF, both ESWT and LCI have good clinical efficacy, but the latter has better clinical efficacy and lower recurrence rate. |
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