跟痛症的中西医临床研究现状

Heel Pain: Clinical Research Status of Integrated Traditional Chinese and Western Medicine

摘要: 跟痛症是中老年常见的慢性负重位疼痛，缠绵反复，可致行走障碍并显著降低生活质量。西医以跖筋膜退变、骨高压、神经卡压等为主要病因，阶梯给予NSAIDs、冲击波、PRP或内镜松解；中医辨证“肝肾亏虚、瘀滞、寒湿”，外治针刺、熏洗、小针刀、牵拉等疗效确切。目前治疗趋向微创化、个体化，但缺少大样本循证证据与中西医协同方案。本文综述近五年跟痛症的中西医临床进展，旨在为构建精准、安全的综合管理策略提供科学依据。

Abstract: Heel pain is a chronic, load-bearing pain commonly seen in middle-aged and older adults; it tends to linger and recur, can impair walking and markedly reduces quality of life. Western medicine attributes it chiefly to plantar-fascia degeneration, intra-osseous hypertension and nerve entrapment, and manages it stepwise with NSAIDs, shock-wave therapy, PRP or endoscopic release. Traditional Chinese medicine differentiates it as “liver-kidney deficiency, stagnation and cold-damp”, and external treatments such as acupuncture, herbal fumigation, needle-knife and stretching yield reliable efficacy. Current therapies trend toward minimal invasiveness and personalization, but large-sample evidence and integrated Chinese-Western protocols are lacking. This review summarizes the past five years of clinical progress on heel pain from both medical traditions, aiming to provide scientific evidence for building a precise and safe comprehensive management strategy.