近十年低强度脉冲超声在肌骨疾病治疗中的应用进展

doi:10.12122/j.issn.1673-4254.2025.03.24

摘要/Abstract

摘要：

肌肉骨骼疾病是一种病变广泛且发病率高的疾病，存在巨大的疾病负担，长期的药物治疗面临着药物毒副作用和治疗效果不佳的困境。低强度脉冲超声（LIPUS）是以低强度输送并以脉冲波模式输出的特殊类型的超声，具有最小的热效应的同时又能保证声能向目标组织的稳定输出，能够为肌肉骨骼疾病的治疗应用提供无创且疗效显著的物理刺激。在动物和临床研究中，LIPUS已被证明可以加速新鲜骨折、骨不连的愈合。LIPUS在软组织再生和抑制炎症反应方面的有效性也已证实。近年来相关研究表明，LIPUS在骨骼肌损伤治疗以及再生修复中具有巨大前景。本综述阐述了 LIPUS在常见的肌肉骨骼疾病，包括骨折与骨不连、肌肉损伤和骨关节炎中的机制研究以及临床治疗应用中的最新进展及其相关机制，介绍了目前市场上LIPUS设备的参数标准，归纳总结相关治疗手段及当前面临的问题和挑战，并展望未来研究方向，旨在系统梳理LIPUS在常见肌骨疾病中的治疗策略，为LIPUS的治疗和应用提供参考。

关键词: 低强度脉冲超声, 骨折与骨不连, 肌肉损伤再生修复, 骨关节炎, 临床应用

Abstract:

Musculoskeletal disorders (MSDs) are characterized by extensive pathological involvement and high prevalence and cause a significant disease burden. Long-term drug administration often causes by adverse effects with poor therapeutic efficacy. Low-intensity pulsed ultrasound (LIPUS), as a specialized therapeutic modality, delivers acoustic energy at a low intensity in a pulsed wave mode, thus ensuring stable energy transmission to the target tissues while minimizing thermal effects. This non-invasive approach has demonstrated significant potential for MSD treatment by delivering effective physical stimulations. Extensive animal and clinical studies have demonstrated the efficacy of LIPUS for accelerating the healing process of fresh fractures and nonunions, promoting soft tissue regeneration and suppressing inflammatory responses. Emerging evidence suggests promising applications of LIPUS in skeletal muscle injury treatment and promoting tissue regeneration and repair. This review outlines the recent advancements and mechanistic studies of LIPUS for treatment of common MSDs including fractures, nonunions, muscle injuries, and osteoarthritis, addressing also the technical parameters of commercially available LIPUS devices, current therapeutic approaches, the existing challenges, and future research directions.

Key words: low-intensity pulsed ultrasound, fracture and nonunion of bones, muscle injury regeneration and repair, osteoarthritis, clinical application

富丽萍, 袁立霞, 王杰, 陈学蓝, 柯桂芝, 黄煜, 杨心仪, 刘刚. 近十年低强度脉冲超声在肌骨疾病治疗中的应用进展[J]. 南方医科大学学报, 2025, 45(3): 661-668.

Liping FU, Lixia YUAN, Jie WANG, Xuelan CHEN, Guizhi KE, Yu HUANG, Xinyi YANG, Gang LIU. Advances of low-intensity pulsed ultrasound for treatment of musculoskeletal disorders in the past decade[J]. Journal of Southern Medical University, 2025, 45(3): 661-668.

图/表 3

图1 LIPUS在骨折愈合的机制

Fig.1 Mechanism of low-intensity pulsed ultrasound (LIPUS) for promoting fracture healing.

图2 LIPUS在肌肉疾病的机制研究

Fig.2 Mechanisms of LIPUS for treatment of myopathies.

图3 LIPUS在骨关节炎的机制研究

Fig.3 Mechanism of LIPUS for treatment of osteoarthritis.

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