| Objective: In the process of the treatment of plantar fasciitis(PF)in extracorporeal shock wave therapy(ESWT)supplemented with external application of Ming Xiong ointment,high-frequency ultrasound(HFUS)was used to observe the changes of plantar fasciitis before and after treatment,and to explore the clinical value of HFUS in evaluating the therapeutic effect of plantar fasciitis.Methods: Subjects were patients with unilateral plantar fasciitis who were admitted to Dalian Hospital of Traditional Chinese Medicine from December 2018 to December2019.A total of 40 patients with unilateral plantar fasciitis were collected according to the established criteria.40 patients were randomly divided into two groups: Group Ⅰ-extracorporeal shock wave supplemented with Ming Xiong ointment topical treatment Group Ⅱ-pure extracorporeal shock wave.Each group has 20 cases.Type 0S medical extracorporeal ballistic shock wave treatment device instrument produced by STORZ Medical Instrument Company was selected as the instrument for extracorporeal shock wave therapy in this experiment.The operating frequency of shock wave is 9 Hz,and the Ashi Xue of the heel is treated.The energy flow density is 0.15 ~ 0.20 MJ per square millimeter.The number of hits is about 1000 ~ 1500.The treatment is performed every2 days,every 7 times is a treatment cycle.For GroupⅠ,after each standardization of extracorporeal shock wave treatment,additional Ming Xiong ointment was applied to Ashi Xue of the heel for 12 hours,and then wrapped with sterile dressings.The Visual Analogue Scale(VAS)of pain was collected before,2 weeks after,and 4 weeks after treatment,and the efficacy was assessed using a weighted method.The changes before and after treatment were compared.The thickness of the plantar fascia,elastic score and blood flow index of the plantar fascia of the subjects were collected by HFUS in three periods.The corresponding ultrasonic indicators of GroupⅠ and Ⅱwere compared before treatment,2 weeks after treatment,and 4 weeks after treatment,to observe the difference in therapeutic effect between two different treatment methods,and to analyze the correlation with clinical efficacy.Results: 1.There was no statistically significant difference in VAS score,the thickness of the plantar fascia,elastic score and blood flow index between GroupⅠ andⅡ before treatment(p>0.05).2.After 4 weeks of treatment,VAS scores of Group Ⅰ and Ⅱ were significantly lower(Group Ⅰ dropped from 7.40±0.82 to 1.60±0.75,Group Ⅱ dropped form7.20±0.77 to 2.15±0.75)compared with before treatment,and the difference was statistically significant(p<0.05).The cure rate obtained by the weighted method,indicates that the cure of Group Ⅰ(75%)was higher than that of Group Ⅱ(40%),and the difference was statistically significant(p<0.05).3.After 4 weeks of treatment,the thickness of plantar fascia in Group Ⅰ and Group Ⅱ decreased significantly compared with before treatment(Group Ⅰ dropped form 5.38±0.40 mm to 4.10±0.28 mm,Group Ⅱ dropped form 5.35±0.41 mm to4.38±0.32mm),and the difference was statistically significant(p<0.05).The thinning degree of plantar fascia thickness in Group Ⅰ(1.275±0.155mm)was more significant than that in Group Ⅱ(0.970±0.138mm),and the difference was statistically significant(p < 0.05).The elastic scores of Group Ⅰ and Group Ⅱ also decreased significantly compared with before treatment(Group Ⅰ dropped form 2.70±0.47 to1.30±0.47,Group Ⅱ dropped form 2.80±0.41 to 1.85±0.81),and the difference was statistically significant(p<0.05).The degree of elastic score reduction in Group Ⅰ(1.400±0.503)was more significant than that in Group Ⅱ(0.950±0.489),and the difference was statistically significant(p<0.05).After only 2 weeks of treatment,the blood flow index of Group Ⅰ and Group Ⅱ increased significantly before treatment(Group Ⅰ increased form 3.52±0.48 to 5.26±0.47,Group Ⅱ increased form 3.61±0.37 to 4.71±0.34),and the difference was statistically significant(p<0.05).The degree of blood flow index increase in Group Ⅰ(1.737±0.579)was more significantly than that in Group Ⅱ(1.137±0.245),and the difference was statistically significant(p<0.05).4.There was a good correlation between the thickness and elasticity of plantar fascia and the cure rate of PF(the areas under the curve 0.838、0.761,p<0.05),there was no significant correlation between the blood flow index of plantar fascia and the cure rate of PF(the areas under the curve 0.437,p>0.05).Conclusion: 1.ESWT applied Ming Xiong ointment for external treatment and ESWT were effective for plantar fasciitis.Compared with ESWT alone,the therapeutic effect of external application of Mingxiong ointment combined with extracorporeal shock wave is more effective,which dramatically increases the cure rate of plantar fascia.2.The thickness and elasticity score of plantar fascia by HFUS can be used as the effect index of clinical treatment of plantar fasciitis. |
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