刘旸　　杨丁　　武玲华

[摘要] 目的 探討体外冲击波联合抗阻运动康复训练对肱骨外上髁炎的疗效及对肘功能的影响。 方法 选择2019年4月至2020年4月航天中心医院康复医学科收治的肱骨外上髁炎患者80例作为研究对象。采用随机数表法分为两组，每组各40例。对照组接受ESWT治疗，观察组在此基础上联合抗组运动康复训练治疗。治疗4周时比较治疗效果，记录治疗前、治疗4周DASH评分、VAS评分、Barthel指数变化及不良反应发生情况。 结果 观察组总有效率为92.50%，明显高于对照组的75.00%，差异有统计学意义（P<0.05）;治疗4周，两组的DASH评分、VAS评分均降低，观察组低于对照组，两组Barthel指数均升高，观察组高于对照组，差异有统计学意义（P<0.05）;治疗过程中，两组患者均未出现感染、烫伤等不良反应。 结论 ESWT联合抗阻运动康复训练治疗肱骨外上髁炎疗效显著，可有效缓解疼痛，促进肘功能恢复，安全性高，建议临床推广使用。

[关键词] 肱骨外上髁炎;体外冲击波;抗阻运动康复训练;肘功能;疼痛

[中图分类号] R684.3          [文献标识码] B          [文章编号] 1673-9701（2021）11-0081-03

Study on the effect of extracorporeal shock wave combined with resistance exercise rehabilitation training on external humeral epicondylitis and its influence on elbow function

LIU Yang   YANG Ding   WU Linghua

Department of Rehabilitation Medicine， Aero Space Center Hospital， Beijing   100049， China

[Abstract] Objective To explore the effect of extracorporeal shock wave combined with resistance exercise rehabilitation training on external humeral epicondylitis and its influence on elbow function. Methods A total of 80 patients with external humeral epicondylitis admitted to the Department of Rehabilitation Medicine of the Aero Space Center Hospital from April 2019 to April 2020 were selected as the research objects. They were divided into two groups according to the random number table method， with 40 cases in each group. The control group received ESWT treatment. The observation group was treated with resistance exercise rehabilitation training treatment on this basis. The treatment effect was compared at four weeks of treatment. The changes in DASH score， VAS score， Barthel index， and adverse reactions were recorded before and four weeks after treatment. Results The total effective rate of the observation group was 92.50%， which was significantly higher than 75.00% of the control group， and the difference was statistically significant（P<0.05）. After 4 weeks of treatment， the DASH score and VAS score of the two groups decreased， and the scores of the observation group were lower than those of the control group. The Barthel index increased in the two groups， and the Barthel index of the observation group was higher than that of the control group. The difference was statistically significant（P<0.05）. During the treatment， there were no adverse reactions such as infection and burns in the two groups. Conclusion ESWT combined with resistance exercise rehabilitation training has a significant effect on the treatment of external humeral epicondylitis， which can effectively relieve pain， promote the recovery of elbow function， and has high safety. It is recommended for clinical use.

[Key words] External humeral epicondylitis; Extracorporeal shock wave; Resistance exercise rehabilitation training; Elbow function; Pain

肱骨外上髁炎是骨科门诊常见疾病，属于一种慢性运动损伤，患病率逐年递增且日趋低龄化，其症状主要表现为疼痛、伸腕握物无力，具有自限性，病情迁延不愈，严重影响患者的工作及生活[1]。临床治疗肱骨外上髁炎的方式方法较多，如理疗、封闭、针灸及药物治疗等，虽可缓解症状，但效果均不理性，治疗后易复发，更甚者需要接受手术治疗[2]。体外冲击波（Extracorporeal shock wave，ESWT）在国内为运用较为广泛，已被证实可有效改善肱骨外上髁炎患者的疼痛，但对患者握力改善效果尚不明确[3]。随着研究的不断深入，抗阻运动康复训练治疗肱骨外上髁炎获得临床灌注，其不仅可缓解疼痛，同时可改善患者的握力，但其有效性存在一定争议。鉴于此，笔者开展了ESWT联合抗组运动康复训练治疗肱骨外上髁炎的研究，现报道如下。……