Erector Spinal Plane Block Combined With Radial Shock Wave Therapy In The Treatment Of Erector Spinae Myofascial Pain Syndrome

Objective:To analyze the clinical efficacy of erector spinae plane block combined with extracorporeal shock wave therapy in the treatment of erector spinae MPS to provide reference for theclinical applicationofextended erectorspinaeplaneblock.Methods:According to the selection and exclusion criteria,90 patients with erector spinae myofascial pain syndrome diagnosed in the pain department of our hospital between September2019 and September 2020 were selected.90 patients were randomly divided into group A,group B,and group C,with 30 cases in each group.Patients in group A were given erector spinae plane block therapy,patients in group B were given extracorporeal shock wave therapy,and patients in group C were given erector spinal plane block combined with extracorporeal shock wave therapy.The visual analogue scale(VAS),Pittsburgh sleep quality index(PSQI),and self-rating asnxiety scale(SAS)were used to evaluate the patients pain,sleep index anxiety evaluation,and using the modified Macnab efficacy evaluation criteria to evaluate the therapeutic effect.The gender,age,course of disease,VAS,PSQI and SAS at admission,VAS,SAS and modified Macnab evaluation at 1 week,1 month,3months and 6 months after treatment,and PSQI at 1 month,3 months and 6 months after treatment wererecorded.Result:(1)VAS:The VAS scores of patients in groups A,B,and C decreased at 1 week,1 month,3months,and 6 months after treatment,the difference was statistically significant(P < 0.05);Group A was compared with group C,the VAS scores of patients 1 week and 1 month after the end of treatment were not statistically different(P > 0.05);Compared with group A and group B,and group B and group C,the VAS scores of patients 1 week and 1 month after the end of treatment were compared,the difference was statistically significant(P < 0.05).Compared with group A and group B,group A and group C,group B and group C,the VAS scores of 3 months and 6 months after treatmentended,thedifferencewas statisticallysignificant(P< 0.05).(2)PSQI:PSQI of patients in groups A,B and C at the end of treatment in 1 month,3 month and6 month was lower than that at admission,and the difference was statistically significant compared with that before treatment(P < 0.05).Compared with the PSQI of group A,group B,and group C at thesametime,thedifferencewasstatisticallysignificant(P< 0.05).(3)SAS:The SAS scores in groups A,B and C at 1 week,1 month,3 months and 6 months after treatment were lower than those at admission,and the difference was statistically significant(P <0.05).1 week,1 month,3 months and 6 months after the end of treatment in group C and group A,group C andgroup B,group Aandgroup B,thedifferenceswerestatisticallysignificant(P < 0.05).(4)Improved Macnab evaluation:The effective rates of group A,B and C were not statistically significant 1 week after treatment(P > 0.05).The effective rates of group A,B and C were statistically significant in 1 month,3 month and 6 month after treatment(P < 0.05).The excellent and good rates of group A,B and C were not statistically significant at 1 week and 1 month after treatment(P >0.05).The excellent and good rates of group A,group B and group C were statistically significant in 3month and 6 month after treatment(P < 0.05).Trend chi-square test results with time as the factor:A,B,C three groups of effective rate was not statistically significant(P > 0.05);The excellent and good rates of group A,B and C were statistically significant(P < 0.05).The excellent and good rate of group C and group B showed a statistically significant upward trend over time(P < 0.05).The excellentandgoodrateofgroup Adecreasedwithtime(P< 0.05).(5)During the treatment of the three groups of patients,there were no adverse events such as drugallergy,neurovascularinjury,punctureofthepleura,ordamagetothelungtissue.Conclusion:(1)The combination therapy of ESPB and RSWT were more obvious than RSWT and ESPB in therapeuticeffect,sleepqualityimprovementand anxietyrelief;(2)The short-term efficacy of ESPB was better than that of RSWT;The long-term efficacy of RSWTwasbetterthanthatof ESPB.