广西医学

目的探讨肩部触发点体外冲击波治疗联合核心肌群运动训练在肩袖损伤中的应用效果。方法将85例肩袖损伤患者随机分为单一组（n=42）和联合组（n=43）。单一组患者给予肩部触发点体外冲击波治疗，联合组患者给予肩部触发点体外冲击波治疗联合核心肌群运动训练。比较两组患者治疗后的临床疗效，以及治疗前后的肩关节功能、肩关节评分、肩关节活动范围及肩关节疼痛程度。结果治疗后，联合组患者的总有效率高于单一组（P<0.05）。治疗后，两组患者Constant⁃Murley肩关节功能评分量表总分及其疼痛、日常活动、关节活动范围、肌力维度得分高于治疗前，且联合组的上述得分高于单一组（P<0.05）；两组患者加州大学肩关节评分量表总分及其疼痛、功能、肩关节屈曲角度、肩关节屈曲肌力及对治疗满意度维度得分高于治疗前，且联合组上述得分高于单一组（P<0.05）；两组患者的肩关节屈曲、外展、侧位内旋、侧位外旋角度大于治疗前，且联合组上述角度大于单一组（P<0.05）；两组患者的视觉模拟量表（VAS）评分均随治疗时间延长而降低，治疗6周后、12周后，联合组患者的VAS评分低于单一组（P<0.05）。结论肩部触发点体外冲击波治疗联合核心肌群运动训练治疗肩袖损伤的效果显著，可减轻患者的疼痛程度，改善肩关节功能和活动范围，效果优于单纯肩部触发点体外冲击波治疗。

Objective To investigate the application effect of extracorporeal shock wave therapy at shoulder trigger points combined with core muscle group exercise training in rotator cuff injury. Methods A total of 85 patients with rotator cuff injury were randomly divided into single group (n=42) or combined group (n=43). The single group received extracorporeal shock wave therapy at shoulder trigger points, while the combined group received extracorporeal shock wave therapy at shoulder trigger points combined with core muscle group exercise training. The clinical efficacy after treatment, as well as shoulder joint function, shoulder joint scores, shoulder joint range of motion, and shoulder joint pain severity before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the combined group was higher than that of the single group (P<0.05). After treatment, the total score of the Constant⁃Murley Shoulder Score scale and its dimension scores of pain, activities of daily living, range of motion, and muscle strength in both groups were higher than those before treatment, and the above scores in the combined group were higher than those in the single group (P<0.05). The total score of the University of California at Los Angeles Shoulder Scale and its dimension scores of pain, function, shoulder flexion angle, shoulder flexion muscle strength, and satisfaction with treatment in both groups were higher than those before treatment, and the above scores in the combined group were higher than those in the single group (P<0.05). The angles of shoulder flexion, abduction, lateral internal rotation, and lateral external rotation in both groups were greater than those before treatment, and the above angles in the combined group were greater than those in the single group (P<0.05). The Visual Analogue Scale (VAS) scores of both groups decreased with the extension of treatment time, and after 6 weeks and 12 weeks of treatment, the VAS score of the combined group was lower than that of the single group (P<0.05). Conclusion Extracorporeal shock wave therapy at shoulder trigger points combined with core muscle group exercise training is effective in treating rotator cuff injury, which can reduce the degree of pain and improve shoulder joint function and range of motion, with superior effect to single extracorporeal shock wave therapy at shoulder trigger points.