Costa M L, Shepstone L, Donell S T, Thomas T L
The Norfolk and Norwich University Hospital, Norwich, UK.
Clin Orthop Relat Res. 2005 Nov;440:199-204. doi: 10.1097/01.blo.0000180451.03425.48.
Shock wave therapy has been used for treatment of several soft tissue disorders that are characterized by chronic pain. We sought to determine if shock wave therapy reduces chronic Achilles tendon pain. Forty-nine patients were enrolled in a double-blind randomized placebo-controlled trial. Each patient was treated once a month for 3 months. The primary outcome measure was a reduction in Achilles tendon pain during walking. At the end of the trial, we found no difference in pain relief between the shock wave therapy group and the control group. There were two patients (62 years and 65 years) with tendon ruptures in the treatment group, suggesting caution when treating older patients. These results provide no support for the use of shock wave therapy for treatment of patients with chronic Achilles tendon pain. However, the confidence intervals include the potential for a clinically relevant treatment effect.
Therapeutic study, Level I (systematic review of Level I RCTs-and study results were homogenous). See the Guidelines for Authors for a complete description of levels of evidence.
冲击波疗法已被用于治疗多种以慢性疼痛为特征的软组织疾病。我们试图确定冲击波疗法是否能减轻慢性跟腱疼痛。49名患者参与了一项双盲随机安慰剂对照试验。每位患者每月接受一次治疗，为期3个月。主要结局指标是步行时跟腱疼痛的减轻。试验结束时，我们发现冲击波疗法组和对照组在疼痛缓解方面没有差异。治疗组有两名患者（62岁和65岁）发生肌腱断裂，提示在治疗老年患者时需谨慎。这些结果不支持使用冲击波疗法治疗慢性跟腱疼痛患者。然而，置信区间包括了具有临床相关治疗效果的可能性。
治疗性研究，I级（I级随机对照试验的系统评价——研究结果具有同质性）。有关证据水平的完整描述，请参阅作者指南。
