目的：探讨聚焦体外冲击波疗法(FESWT)治疗产后骶髂关节(SIJ)功能障碍的疗效。
方法：共纳入90例SIJ功能障碍患者，并随机分配至FESWT，手动治疗（MT），或联合治疗（CT）组。入院时测量疼痛强度和Oswestry残疾指数（ODI）评分，治疗1周和2周后。评估各组的治疗效果和不良事件。
结果：三组间临床资料无显著差异，疼痛强度，入院时ODI评分(均P>0.05)。治疗1周后,与MT相比，FESWT表现出相似的疼痛强度和较低的ODI评分（P<0.001）。治疗2周后,FESWT的疼痛和ODI与MT相似。1周后CT疼痛低于MT，但2周后低于FESWT。此外，我们确定了治疗方法和持续时间与疼痛强度(Fgroup*时间=5.352,P=0.001)和ODI评分(Fgroup*时间=5.902,P<0.001)之间的交互作用.FESWT组改善率最高，为66.7%，而CT组治愈率最高，为73.3%。在2个月的随访期间，没有观察到任何患者的不良事件。
结论：与MT相比，治疗1周后，FESWT主要降低ODI评分，而不是疼痛。2周后,FESWT缓解疼痛的效果不如MT。
OBJECTIVE: To investigate the effectiveness of focused extracorporeal shock wave therapy (FESWT) in treating postpartum sacroiliac joint (SIJ) dysfunction.
METHODS: A total of 90 patients with SIJ dysfunction were included and randomly assigned to FESWT, manual therapy (MT), or combination therapy (CT) groups. Pain intensity and Oswestry Disability Index (ODI) score were measured upon admission, after 1 and 2 weeks of treatments. The treatment efficacy and adverse events of each group were also assessed.
RESULTS: There were no significant differences among three groups regarding clinical data, pain intensity, and ODI score on admission (all P > 0.05). After 1 week of treatment, FESWT exhibited similar pain intensity and lower ODI score (P < 0.001) compared to MT. After 2 weeks of treatment, the pain and ODI in FESWT were similar with MT. The pain in CT was lower than MT after 1 week, but lower than FESWT after 2 weeks. Furthermore, we identified interaction effects between treatment method and duration in relation to pain intensity (Fgroup*time = 5.352, P = 0.001) and ODI score (Fgroup*time = 5.902, P < 0.001). FESWT group exhibited the highest improvement rate of 66.7%, while CT group achieved the highest cure rate of 73.3%. No adverse events were observed in any of the patients during 2 months follow-up period.
CONCLUSIONS: Compared to MT, FESWT mainly reduced the ODI score rather than pain after 1 week of treatment. After 2 weeks, the effect of FESWT in relieving the pain was inferior to the MT.
PDF(Pubmed)