體外震波療法可治療慢性肩部鈣化腱炎


  March 7, 2003 -根據發表在三月號《風濕病年報》(Annals of Rheumatic Disease)中的單盲研究顯示,體外震波療法(ESWT)可有效治療慢性肩部鈣化腱炎,有1三分之一的治療團體可以完全吸收鈣化沈積物,另外三分之二也出現部分吸收的情形,相較於控制組則完全沒有吸收。研究人員建議這種療法可供醫師作為替代療法。
  
  ESWT是用震波以百萬分之一秒的壓力脈衝,根據不同治療部位使用能量,以減少鈣化沈積物的症候及碎裂所產生的疼痛。義大利Siena大學的R. Cosentino及同事表示,許多研究報告證實這種療法對肩部鈣化腱炎,無論高或低的能量,都會出現良好結果。
  
  此研究隨機調查了70名罹患慢性症候的肩部鈣化腱炎病患,其中35名病患接受ESWT,另外35名接受模擬治療。最後結果顯示,ESWT組疼痛顯著減輕,且肩部功能顯著增加,但控制組則沒有改善。X光發現接受ESWT的病患,有40%出現部分鈣化沈積物吸收,31%完全吸收,但模擬治療組則沒有吸收。
  
  R. Cosentino表示,ESWT耐藥性良好、安全及臨床輻射反應,可以作為傳統療法難以治療的慢性肩部鈣化腱炎的替代療法。
  

Extracorporeal Shock Wave Ther

By Laurie Barclay, MD
Medscape Medical News

March 7, 2003 — Extracorporeal shock wave therapy (ESWT) is effective for chronic calcific tendinitis of the shoulder, according to the results of a single-blind study reported in the March issue of the Annals of Rheumatic Disease. One-third of the treatment group had complete resorption of calcium deposits and others had partial resorption, compared with none of the controls. The investigators suggest that this should be considered an alternative treatment.

"ESWT is based on the use of shock waves, pressure impulses with a duration of microseconds, capable of producing, depending on the energy used at the level of the areas treated, a reduction of painful symptomatology and fragmentation of calcific deposits," write R. Cosentino and colleagues from the University of Siena in Italy. "Many authors have reported good results in calcifying tendinitis of the shoulder with low and high energy."

In this randomized study of 70 patients with chronic, symptomatic, calcifying tendinitis of the shoulder, 35 patients received ESWT and 35 received simulated treatment. The ESWT group had a significant decrease in pain and a significant increase in shoulder function, but the control group did not. X-rays revealed partial resorption of calcium deposits in 40% and complete resorption in 31% of patients who received ESWT, but no resorption in any patients who received sham treatment.

"With its good tolerance, safety, and clinical-radiological response, ESWT should be considered as an alternative treatment for chronic calcific tendinitis of the shoulder refractory to conventional treatments," the authors write.

Ann Rheum Dis. 2003;62:248-250

Reviewed by Gary D. Vogin, MD

    
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