体外冲击波联合高能激光照射对腰背部肌筋膜疼痛综合征的应用效果与护理研究

Study on the Application Effect and Nursing of Extracorporeal Shock Wave Combined with High-Intensity Laser Irradiation for Lumbodorsal Myofascial Pain Syndrome

摘要: 目的：探讨体外冲击波(Extracorporeal Shock Wave Therapy, ESWT)联合高能量激光(High-Intensity Laser Therapy, HILT)治疗腰背部肌筋膜疼痛综合征(MPS)的临床护理干预模式及应用效果。方法：选取2025年7月~2025年12月天津市第一中心医院疼痛治疗门诊收治的40例MPS患者(男15例，女25例，年龄40 ± 7.411岁)采用前瞻性自身前后对照设计，在 ESWT联合HILT治疗基础上实施护士主导的系统化护理干预，通过重复测量方差分析比较干预前(T0)、1疗程后(T1)、2疗程后(T2)及3个月后(T3)的指标变化。结果：干预后各时间点患者VAS评分、HADS-A及HADS-D亚评分均较治疗前显著降低(P < 0.05)，T3时VAS评分降至(2.20 ± 1.363)分，HADS-D评分降至(4.72 ± 2.298)分，HADS-A评分降至(4.30 ± 2.399)分；Pearson相关分析显示VAS评分与HADS-A评分呈中等强度正相关(r = 0.45, P < 0.001)；门诊满意度各维度均值为4.75~5.0分，其中“尊重与尊严”维度满意度达100%。结论：对MPS患者实施ESWT联合HILT治疗的同时，辅以护士主导的动态评估、心理支持、健康宣教及长期随访等系统化护理干预，可有效缓解患者疼痛症状，改善焦虑抑郁情绪，构建良好的医患信任关系，显著提升门诊护理质量与患者满意度，为慢性疼痛患者的身心共治提供实践参考。

Abstract: Objective: To investigate the clinical nursing intervention mode and application effect of extracorporeal shock wave therapy (ESWT) combined with high-intensity laser therapy (HILT) in the treatment of lumbodorsal myofascial pain syndrome (MPS). Methods: A total of 40 MPS patients (15 males and 25 females, aged 40 ± 7.411 years) admitted to the Pain Treatment Clinic of Tianjin First Central Hospital from July 2025 to December 2025 were enrolled. A prospective self-controlled design was used. On the basis of ESWT combined with HILT treatment, nurse-led systematic nursing interventions were implemented. Repeated-measures analysis of variance was used to compare the changes in indicators before intervention (T0), after 1 course (T1), after 2 courses (T2), and 3 months later (T3). Results: Compared with before treatment, the VAS score, HADS-A score and HADS-D score were significantly decreased at each time point after intervention (P < 0.05). At T3, the VAS score was 2.20 ± 1.363, HADS-D score was 4.72 ± 2.298, and HADS-A score was 4.30 ± 2.399. Pearson correlation analysis showed that VAS score was moderately positively correlated with HADS-A score (r = 0.45, P < 0.001). The mean score of each dimension of outpatient satisfaction was 4.75~5.0, among which the satisfaction rate of “respect and dignity” reached 100%. Conclusion: For MPS patients treated with ESWT combined with HILT, supplementary nurse-led systematic nursing interventions including dynamic assessment, psychological support, health education and long-term follow-up can effectively relieve pain, improve anxiety and depression, establish a good doctor-patient relationship, and significantly improve outpatient nursing quality and patient satisfaction. It provides practical reference for physical and psychological treatment of patients with chronic pain.