LP-PRP对比LR-PRP联合ESWT治疗慢性非止点跟腱腱病的对比研究

doi:10.20223/j.cnki.1000-8535.2025.07.016

广州医药 ›› 2025, Vol. 56 ›› Issue (7): 963-967.DOI: 10.20223/j.cnki.1000-8535.2025.07.016

LP-PRP对比LR-PRP联合ESWT治疗慢性非止点跟腱腱病的对比研究

杨国平¹, 毕声荣¹, 周建国¹, 钱锐¹, 刘振逾¹, 巫路炜², 胡伟全¹, 刘世伟¹

1 赣州市人民医院关节外科（江西赣州 341000）
2 赣州市人民医院创伤急救中心（江西赣州 341000）

收稿日期:2024-07-15 出版日期:2025-07-20 发布日期:2025-08-28
基金资助:
江西省卫生健康委科技计划（202311832）

Comparative study of LP-PRP and LR-PRP combined with ESWT in the treatment of chronic non-insertional Achilles tendinopathy

YANG Guoping¹, BI Shengrong¹, ZHOU Jianguo¹, QIAN Rui¹, LIU Zhenyu¹, WU Luwei², HU Weiquan¹, LIU Shiwei¹

1 Department of Joint Surgery,Ganzhou People's Hospital,Ganzhou 341000,China
2 Ganzhou People's Hospital Trauma Emergency Center,Ganzhou 341000,China

Received:2024-07-15 Online:2025-07-20 Published:2025-08-28

摘要/Abstract

摘要： 目的对比乏白细胞富血小板血浆（LP-PRP）与富白细胞富血小板血浆（LR-PRP）联合体外冲击波疗法（ESWT）治疗慢性非止点跟腱腱病（NIAT）的临床价值。方法选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者,以随机数表法分为两组,即对照组和观察组各40例,观察组予LP-PRP联合ESWT治疗,对照组予LR-PRP联合ESWT治疗;于治疗前、第一次治疗后1个月、3个月比较两组疼痛度[视觉模拟量表（VAS）评分]、跟腱病变程度[维多利亚体育研究所跟腱评估问卷（VISA-A）]、跟腱功能（Arner-Lindholm跟腱功能评分）,并比较两组并发症的发生率。结果两组在治疗后1个月、3个月的VAS评分下降,VISA-A评分升高,且观察组治疗后3个月的VAS评分（1.05±0.31）分低于对照组的（1.82±0.45）分,VISA-A评分（83.35±5.58）分高于对照组的（76.28±5.35）分（F组间与时点交互=338.478、106.663,均P<0.05）;治疗后3个月,观察组跟腱功能（优、良、差各有24、13、3例）优于对照组（优、良、差各有14、16、10例）,差异有统计学意义（Z=2.529,P=0.012）。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义（均P>0.05）。结论与LR-PRP比较,LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度,改善患者跟腱功能。

关键词: 慢性非止点跟腱腱病, 体外冲击波疗法, 富血小板血浆, 跟腱功能

Abstract: Objective To compare the clinical value of leukocyte-poor platelet rich plasma（LP-PRP）and leukocyte-rich platelet rich plasma（LR-PRP）combined with extracorporeal shock wave therapy（ESWT）in the treatment of chronic non -insertional Achilles tendinopathy（NIAT）．Methods Eighty patients with chronic NIAT admitted to Ganzhou People's Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method：a control group and an observation group,with 40 patients in each group．The observation group received LP-PRP combined with ESWT treatment,while the control group received LR-PRP combined with ESWT treatment．The pain level（Visual Analog Scale[VAS]score）,degree of Achilles tendon lesion（Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire[VISA-A]）,and Achilles tendon function（Arner Lindholm Achilles tendon function score）between the two groups were compared before treatment,one month after the first treatment,and three months after treatment,as well as the incidence of complications between the two groups．Results The VAS scores of both groups decreased and the VISA-A scores increased one and three months after treatment．The VAS score of the observation group（1.05±0.31）was lower than that of the control group（1.82±0.45）three months after treatment,while the VISA-A score of the observation group（83.35±5.58）was higher than that of the control group（76.28±5.35）（interaction between group and time point F=338.478,106.663,both P<0.05）．After three months of treatment,the Achilles tendon function of the observation group（24 cases of excellent,13 cases of good,and three cases of poor）was better than that of the control group（14 cases of excellent,16 cases of good,and 10 cases of poor）,and the difference was statistically significant（Z=2.529,P=0.012）．There was no statistically significant difference in VAS score,VISA-A score,and Achilles tendon function between the two groups one month after treatment（all P>0.05）．Conclusions Compared with LR-PRP,LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT,and improving Achilles tendon function．

Key words: chronic non-insertional achilles tendinopathy, extracorporeal shock wave therapy, platelet rich plasma, Achilles tendon function

杨国平, 毕声荣, 周建国, 钱锐, 刘振逾, 巫路炜, 胡伟全, 刘世伟. LP-PRP对比LR-PRP联合ESWT治疗慢性非止点跟腱腱病的对比研究[J]. 广州医药, 2025, 56(7): 963-967.

YANG Guoping, BI Shengrong, ZHOU Jianguo, QIAN Rui, LIU Zhenyu, WU Luwei, HU Weiquan, LIU Shiwei. Comparative study of LP-PRP and LR-PRP combined with ESWT in the treatment of chronic non-insertional Achilles tendinopathy[J]. Guangzhou Medical Journal, 2025, 56(7): 963-967.

参考文献

[1] 姚伟,刘畅,林资范,等.体外冲击波联合肌内效贴治疗跟腱腱病的临床研究[J].体育科研,2019,40(4):88-92,98.
[2] 方剑利,叶海,楼红侃,等.运用经络理论指导体外冲击波治疗跟腱炎临床研究[J].新中医,2020,52(3):161-164.
[3] 于承浩,张益,戚超,等.细胞因子和富血小板血浆对肌腱干细胞的影响[J].中国组织工程研究,2021,25(1):133-140.
[4] 沙明,李慧锋,马松鹤,等.透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的疗效[J].广州医药,2023,54(1):44-47,55.
[5] 施彦. 富血小板血浆联合自体脂肪在大阴唇填充手术中的应用[J].广州医药,2024,55(1):64-67,72.
[6] 林春博,姚军,农桔安,等.不同浓度富血小板血浆促进骨髓间充质干细胞增殖及向软骨细胞分化的实验研究[J].广西医科大学学报,2020,37(12):2147-2152.
[7] 孙兵,车晓明.视觉模拟评分法(VAS)[J].中华神经外科杂志,2012,28(6):654.
[8] 白文博,梁晓军,赵宏谋,等.富血小板血浆与体外冲击波治疗慢性跟腱止点腱病的疗效比较[J].中国骨伤,2023,36(4):351-356.
[9] 郝云甲,王爱国,范家强,等.全关节镜下自体半腱肌及股薄肌肌腱修复MyersonⅢ型陈旧性跟腱断裂的疗效分析[J].中华外科杂志,2020,58(9):718-722.
[10] 杨逸明,王宝剑,张伟,等.非止点性跟腱病超声测值变化及相关性分析[J].中国医药导报,2023,20(18):83-86,91.
[11] 谢黄琼,俞嘉锫,申成春.关节镜手术联合富血小板血浆植入术治疗跟腱末端附着点炎相关关节炎的效果观察[J].现代实用医学,2024,36(2):230-232.
[12] 高超,张航,陈凯文,等.富血小板血浆在急性跟腱断裂治疗中的应用[J].中华创伤骨科杂志,2020,22(1):38-44.
[13] 陈宁,陈崇伟.超声在跟腱病诊断与治疗中的应用进展[J].医学综述,2023,29(4):742-747.
[14] 黄远清,罗锦辉,黄洛.Kessler缝合联合富血小板血浆治疗跟腱断裂[J].中国矫形外科杂志,2021,29(16):1476-1480.
[15] 王莹,李谊,胡浩磊.去白细胞富血小板血浆联合切开复位内固定术治疗下颌骨正中骨折的疗效分析[J].广西医学,2023,45(7):769-772.
[16] 朱赫,姚鸣宇,董亦直,等.富血小板血浆在治疗椎间盘退变中的研究进展[J].临床医学进展,2024,14(4):437-442.
[17] 程浩,陆伟萍,高献忠,等.超声引导下高容量注射与冲击波治疗慢性非止点跟腱腱病的比较[J].临床麻醉学杂志,2019,35(12):1201-1204.
[18] 章松,毛海蛟.富血小板血浆与肌腱干细胞治疗跟腱病的研究进展[J].宁波大学学报(理工版),2023,36(6):114-120.
[19] 谢琦,莫凡,杨渊,等.微创缝合结合自体富血小板血浆治疗急性闭合性跟腱断裂的有效性[J].创伤外科杂志,2021,23(5):332-337.
[20] 孙慧颖,朱崇元,冯国栋,等.含有白细胞的富血小板纤维蛋白的生物学特性及临床应用[J].基础医学与临床,2020,40(12):1706-1710.
[21] ARORA G,ARORA S.Platelet-rich plasma:Where do we stand today? A critical narrative review and analysis[J].Dermatol Ther,2021,34(1):e14343.
[22] 张美荣,李铁山,左安凯,等.贫白细胞富血小板血浆和富白细胞富血小板血浆注射治疗冈上肌撕裂的疗效观察[J].中华物理医学与康复杂志,2025,47(5):456-460.
[23] KAWABATA S,AKEDA K, YAMADA J,et al.Advances in platelet-rich plasma treatment for spinal diseases:A systematic review[J].Int J Mol Sci,2023,24(8):7677.

LP-PRP对比LR-PRP联合ESWT治疗慢性非止点跟腱腱病的对比研究

Comparative study of LP-PRP and LR-PRP combined with ESWT in the treatment of chronic non-insertional Achilles tendinopathy

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