Paoloni Justin A, Appleyard Richard C, Nelson Janis, Murrell George A C
Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia.
Am J Sports Med. 2003 Nov-Dec;31(6):915-20. doi: 10.1177/03635465030310062901.
Extensor tendinosis ("tennis elbow") is a degenerative overuse tendinopathy of the wrist extensors at their attachment to the lateral humeral epicondyle. No treatment has been universally successful. Topical application of nitric oxide has been used effectively to treat fractures and cutaneous wounds in animal models, presumably by stimulation of collagen synthesis in fibroblasts.
To determine whether topical nitric oxide can improve outcome of patients with extensor tendinosis.
Prospective, randomized, double-blinded clinical trial.
Eighty-six patients with extensor tendinosis were randomized into two equal groups; both were instructed to perform a standard tendon rehabilitation program. One group received an active glyceryl trinitrate transdermal patch, and the other group received a placebo patch.
Patients in the glyceryl trinitrate group had significantly reduced elbow pain with activity at 2 weeks, reduced epicondylar tenderness at 6 and 12 weeks, and an increase in wrist extensor mean peak force and total work at 24 weeks. At 6 months, 81% of treated patients were asymptomatic during activities of daily living, compared with 60% of patients who had tendon rehabilitation alone.
Application of topical nitric oxide improved early pain with activity, late functional measures, and outcomes of patients with extensor tendinosis.
伸肌肌腱病（“网球肘”）是腕伸肌在肱骨外上髁附着处的一种退行性过度使用性肌腱病。目前尚无普遍有效的治疗方法。一氧化氮的局部应用已被有效地用于治疗动物模型中的骨折和皮肤伤口，推测是通过刺激成纤维细胞中的胶原蛋白合成来实现的。
确定局部应用一氧化氮是否能改善伸肌肌腱病患者的治疗效果。
前瞻性、随机、双盲临床试验。
86例伸肌肌腱病患者被随机分为两组，两组均接受标准的肌腱康复计划。一组接受活性硝酸甘油透皮贴剂，另一组接受安慰剂贴剂。
硝酸甘油组患者在2周时活动时肘部疼痛明显减轻，在6周和12周时肱骨外上髁压痛减轻，在24周时腕伸肌平均峰值力和总功增加。在6个月时，81%接受治疗的患者在日常生活活动中无症状，而单纯进行肌腱康复的患者这一比例为60%。
局部应用一氧化氮可改善伸肌肌腱病患者早期活动时的疼痛、后期功能指标及治疗效果。
