Tonks J H, Pai S K, Murali S R
The Department of Orthopaedic Surgery, Royal Albert Edward Infirmary (part of Wigan, Wrightington and Leigh NHS Trust), Wigan, UK.
Int J Clin Pract. 2007 Feb;61(2):240-6. doi: 10.1111/j.1742-1241.2006.01140.x.
The relative merits of a watch and wait policy, physiotherapy alone, steroid injection therapy alone, and physiotherapy and steroid injection therapy combined, for the treatment of tennis elbow, were assessed using a prospective randomised controlled trial (RCT) of factorial design. Although RCTs comparing different treatment strategies for tennis elbow have previously been published, to our knowledge none of the previous studies have combined the modalities of physiotherapy and steroid injection as one of the treatment groups, as we have done in this study. Patients who received steroid injection were statistically significantly better for all outcome measures at follow up. No statistically significant effect of physiotherapy nor interaction between physiotherapy and injection was found. On the basis of the results of this study, the authors advocate steroid injection alone as the first line of treatment for patients presenting with tennis elbow demanding a quick return to daily activities.
采用析因设计的前瞻性随机对照试验（RCT），评估了观察等待策略、单纯物理治疗、单纯类固醇注射治疗以及物理治疗与类固醇注射联合治疗网球肘的相对优缺点。尽管此前已发表了比较网球肘不同治疗策略的随机对照试验，但据我们所知，之前的研究均未像本研究这样，将物理治疗和类固醇注射这两种方式合并为一个治疗组。在随访时，接受类固醇注射的患者在所有结局指标上均有统计学意义上的显著改善。未发现物理治疗有统计学意义上的效果，也未发现物理治疗与注射之间存在相互作用。基于本研究结果，作者主张对于要求迅速恢复日常活动的网球肘患者，将单纯类固醇注射作为一线治疗方法。
