摘要目的:观察发散式冲击波(ESWT)治疗老年人肩关节周围炎的临床疗效。方法:回顾性分析2016年7月至2019年1月就诊于安徽医科大学第二附属医院康复医学科诊断为肩关节周围炎的患者82例，分析患者治疗前、治疗后6个月内的视觉模拟评分法(VAS)、Constant Murley肩关节评分(CMS)、关节活动度(ROM)、疗效评定、不良反应和生存分析。结果:与治疗前比较，原发性肩关节周围炎和继发性肩关节周围炎患者治疗后常规康复组和常规康复联合ESWT组老年患者VAS评分、CMS评分、ROM、治疗效果和生存分析均有改善(均 P<0.05)，且在近期(治疗后2周、治疗后1个月)疗效比较中常规康复联合ESWT治疗优于单独常规康复治疗( P<0.05)，在远期效果(治疗后2、4、6个月)比较中两种治疗差异无统计学意义( P>0.05)。对于原发性肩关节周围炎老年患者，常规康复联合ESWT治疗降低VAS评分和改善肩关节功能(CMS评分和ROM)方面均较常规康复组有优势(均 P<0.05)。对于继发性肩关节周围炎老年患者，常规康复联合ESWT治疗在降低VAS中的效果优于常规康复治疗( P<0.05)，而在改善功能方面与常规康复治疗比较差异无统计学意义(均 P>0.05)。 结论:常规康复联合ESWT治疗老年人肩关节周围炎能缓解肩关节疼痛、改善活动度，安全性较好，但长期疗效和常规康复治疗比较无明显差异。

abstractsObjective:To investigate the clinical efficacy of radial extracorporeal shockwave therapy(ESWT)for scapulohumeral periarthritis in the elderly.Methods:A total of 82 patients diagnosed with scapulohumeral periarthritis at the rehabilitation medicine department of our hospital from July 2016 to January 2019 were retrospectively analyzed.The visual analogue score(VAS), Constant-Murley score(CMS), range of motion(ROM), adverse reactions, curative effectiveness and survival analysis were examined before treatment and at several time points within 6 months of treatment.Results:Compared with pre-treatment, the VAS, CMS, ROM, curative effects and survival analysis of patients with primary and secondary scapulohumeral periarthritis improved after treatment in both the conventional rehabilitation therapy group and the conventional rehabilitation therapy combined with ESWT group(all P<0.05). The short-term effects(2 weeks and 1 month after treatment)were better in the conventional rehabilitation therapy combined with ESWT group than in the conventional rehabilitation therapy group( P<0.05). There was no significant difference in long-term effects(2, 4 and 6 months after treatment)between the two groups( P>0.05). For patients with primary scapulohumeral periarthritis, conventional rehabilitation therapy combined with ESWT had advantages over conventional rehabilitation therapy in reducing the VAS score and improving shoulder function(CMS score and ROM)( P<0.05). For patients with secondary scapulohumeral periarthritis, conventional rehabilitation therapy combined with ESWT was better in reducing VAS than conventional rehabilitation therapy( P<0.05), while there was no significant difference in shoulder function improvement between the two groups(all P>0.05). Conclusions:Conventional rehabilitation combined with ESWT can relieve shoulder pain, improve range of motion and has a good safety profile in the treatment of scapulohumeral periarthritis in the elderly, but there is no significant difference in long-term efficacy between conventional rehabilitation therapy and conventional rehabilitation therapy combined with ESWT.