身痛逐瘀汤联合体外冲击波治疗运动员髌腱末端病患者对股四头肌表面肌电和平衡能力的影响(1)
摘要 目的：探究身痛逐瘀湯联合体外冲击波对运动员髌腱末端病(Patellar Tendinopathy，PT)患者股四头肌表面肌电和平衡能力的影响。方法：选取2017年1月至2018年1月安阳市人民医院收治PT患者78例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组39例。对照组常规康复治疗，观察组加用身痛逐瘀汤联合体外冲击波治疗，均同时治疗6周。观察2组患者治疗前、完成治疗股四头肌表面肌电并比较;观察治疗前、治疗后平衡能力变化并比较;观察2组患者治疗前、治疗后在等速肌力、肌肉耐力、疼痛视觉模拟评分法(VAS)评分变化并比较;治疗后比较2组患者疗效情况。结果：治疗后观察组股直肌、股外侧肌、股内侧肌的肌电积分、中位频率较治疗前均显著升高，差异有统计学意义(P<0.05)，对照组治疗前、治疗后以上各指标比较，差异无统计学意义(P>0.05)，治疗后观察组以上各指标高于对照组，差异有统计学意义(P<0.05)。治疗后2组患者240°/s峰力矩、60°/s峰力矩、肌肉耐力屈伸较治疗前均显著升高，VAS评分则显著下降，差异有统计学意义(P<0.05)，治疗后观察组240°/s峰力矩屈、60°/s峰力矩屈、肌肉耐力屈均显著高于对照组，VAS评分显著低于对照组，差异有统计学意义(P<0.05)，而在240°/s峰力矩伸、60°/s峰力矩伸、肌肉耐力伸比较，差异无统计学意义(P>0.05)。治疗后观察组前后轴、左右轴、A2-A6轴、A4-A8轴和圆周轴较治疗前均显著下降，差异有统计学意义(P<0.05)，对照组治疗后较治疗前比较，差异无统计学意义(P>0.05)，治疗后观察组以上各指标均显著低于对照组，差异有统计学意义(P<0.05)。观察组治疗有效率均显著高于对照组，差异有统计学意义(P<0.05)。结论：身痛逐瘀汤联合体外冲击波能通过改善运动员PT股四头肌表面肌电，稳定关节，重建平衡，从而缓解疼痛，改善症状，提高疗效。
关键词 身痛逐瘀汤;体外冲击波;运动员;髌腱末端病;股四头肌表面肌电;平衡能力;等速肌力;视觉模拟评分法;疗效
Abstract Objective：To explore the effects of Shentong Zhuyu Decoction combined with extracorporeal shock wave on surface electromyography and balance of quadriceps femoris on athletes with patellar terminal disease(PT).Methods：A total of 78 PT patients were enrolled in the People′s Hospital of Anyang City from January 2017 to January 2018.They were randomly divided into a control group(39 cases)and an observation group(39 cases)according to the random number table.The control group received routine rehabilitation treatment，while the observation group received Shentong Zhuyu Decoction combined with extracorporeal shock wave for 6 weeks.The surface electromyography of quadriceps femoris before and after treatment was observed and compared between the 2 groups; the changes of balance ability before and after treatment were observed and compared; the changes of isokinetic muscle strength，muscle endurance and pain visual analogue score(VAS score)before and after treatment were observed and compared between the 2 groups; and the curative effect of the 2 groups was compared after treatment.Results： 1)After treatment，the EMG scores and median frequencies of rectus femoris，lateral femoris and medial femoris in the observation group were significantly higher than those before treatment(P<0.05).There was no statistically significant difference in the above indexes before and after treatment in the control group(P>0.05).After treatment，the above indexes in the observation group were significantly higher than those in the control group(P<0.05). 2)After treatment，the 240 degree/s peak moment，60 degree/s peak moment and muscle endurance flexion and extension of the 2 groups were significantly increased than those before treatment，while the VAS score was significantly decreased(P<0.05).After treatment，the 240 degree/s peak moment flexion，60 degree/s peak moment flexion and muscle endurance of the observation group were significantly higher than those of the control group，and the VAS score was significantly lower than that of the control group(P<0.05)，while the differences of 240 degree/s peak moment extension and 60 degree/s peak，and muscle endurance stretching were no significant，without statistical significance(P>0.05). 3)After treatment，the anterior and posterior axes，left and right axes，A2-A6 axes，A4-A8 axes and circumferential axes of the observation group were significantly decreased than before treatment(P<0.05).There was no significant difference in the control group before and after treatment(P>0.05).After treatment，the above indexes of the observation group were significantly lower than those of the control group(P<0.05). 4)The marked efficiency，effective rate and total effective rate of the observation group were significantly higher than those of the control group，and the difference was statistically significant(P<0.05).Conclusion：Shentong Zhuyu Decoction combined with extracorporeal shock wave can relieve pain，improve symptoms and improve curative effects by improving the surface electromyography of PT quadriceps femoris muscle，stabilizing joints and rebuilding balance., http://www.100md.com(邢兰坤 李鑫 何海峰)
关键词 身痛逐瘀汤;体外冲击波;运动员;髌腱末端病;股四头肌表面肌电;平衡能力;等速肌力;视觉模拟评分法;疗效
Abstract Objective：To explore the effects of Shentong Zhuyu Decoction combined with extracorporeal shock wave on surface electromyography and balance of quadriceps femoris on athletes with patellar terminal disease(PT).Methods：A total of 78 PT patients were enrolled in the People′s Hospital of Anyang City from January 2017 to January 2018.They were randomly divided into a control group(39 cases)and an observation group(39 cases)according to the random number table.The control group received routine rehabilitation treatment，while the observation group received Shentong Zhuyu Decoction combined with extracorporeal shock wave for 6 weeks.The surface electromyography of quadriceps femoris before and after treatment was observed and compared between the 2 groups; the changes of balance ability before and after treatment were observed and compared; the changes of isokinetic muscle strength，muscle endurance and pain visual analogue score(VAS score)before and after treatment were observed and compared between the 2 groups; and the curative effect of the 2 groups was compared after treatment.Results： 1)After treatment，the EMG scores and median frequencies of rectus femoris，lateral femoris and medial femoris in the observation group were significantly higher than those before treatment(P<0.05).There was no statistically significant difference in the above indexes before and after treatment in the control group(P>0.05).After treatment，the above indexes in the observation group were significantly higher than those in the control group(P<0.05). 2)After treatment，the 240 degree/s peak moment，60 degree/s peak moment and muscle endurance flexion and extension of the 2 groups were significantly increased than those before treatment，while the VAS score was significantly decreased(P<0.05).After treatment，the 240 degree/s peak moment flexion，60 degree/s peak moment flexion and muscle endurance of the observation group were significantly higher than those of the control group，and the VAS score was significantly lower than that of the control group(P<0.05)，while the differences of 240 degree/s peak moment extension and 60 degree/s peak，and muscle endurance stretching were no significant，without statistical significance(P>0.05). 3)After treatment，the anterior and posterior axes，left and right axes，A2-A6 axes，A4-A8 axes and circumferential axes of the observation group were significantly decreased than before treatment(P<0.05).There was no significant difference in the control group before and after treatment(P>0.05).After treatment，the above indexes of the observation group were significantly lower than those of the control group(P<0.05). 4)The marked efficiency，effective rate and total effective rate of the observation group were significantly higher than those of the control group，and the difference was statistically significant(P<0.05).Conclusion：Shentong Zhuyu Decoction combined with extracorporeal shock wave can relieve pain，improve symptoms and improve curative effects by improving the surface electromyography of PT quadriceps femoris muscle，stabilizing joints and rebuilding balance., http://www.100md.com(邢兰坤 李鑫 何海峰)