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自体血与皮质类固醇局部注射治疗外侧肘肌腱病的短期疗效:一项随机临床试验

Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy.

作者信息

Kazemi Marzieh, Azma Kamran, Tavana Behrooz, Rezaiee Moghaddam Farid, Panahi Ali

机构信息

Department of Physical Medicine and Rehabilitation School of Medicine, Army University of Medical Sciences, Islamic Republic of Iran, Western Fatemi, Tehran, Islamic Republic of Iran.

出版信息

Am J Phys Med Rehabil. 2010 Aug;89(8):660-7. doi: 10.1097/PHM.0b013e3181ddcb31.

Abstract

OBJECTIVE

To compare local corticosteroid with autologous blood injections for the short-term treatment of lateral elbow tendinopathy.

DESIGN

A single blind, randomized clinical trial was performed in an outpatient clinic at a university hospital. Sixty patients aged 27-64 yrs with a new episode of tennis elbow were recruited. Thirty patients were randomized to methylprednisolone and 30 to autologous blood group over 1 yr. Severity of pain within last 24 hrs; limb function; pain and strength in maximum grip; disabilities of the arm, shoulder, and hand quick questionnaire (Quick DASH) scores; modified Nirschl scores; and pressure pain threshold were evaluated before injection and at 4 and 8 wks after injection. We analyzed our data with the chi and t test.

RESULTS

Within-group analyses showed better results for autologous blood (all P values <0.001 except for grip strength, P = 0.005). In the corticosteroid group, differences in severity of pain (P = 0.008) and grip strength (P = 0.001) were significant. At 4 wks, between-group analyses showed superiority of autologous blood for severity of pain (P = 0.001), pain in grip (P = 0.002), pressure pain threshold (P = 0.031), and Quick DASH questionnaire score (P = 0.004). There were no significant differences in modified Nirschl score, grip strength, and limb function. At 8 wks, autologous blood was more effective in all the outcomes (all P values <0.001).

CONCLUSIONS

Autologous blood was more effective in short term than the corticosteroid injection.

摘要

目的

比较局部注射皮质类固醇与自体血注射用于短期治疗外侧肘肌腱病的效果。

设计

在一所大学医院的门诊进行了一项单盲随机临床试验。招募了60例年龄在27 - 64岁的新发网球肘患者。在1年多的时间里,30例患者被随机分配接受甲基强的松龙治疗,30例患者接受自体血治疗。在注射前以及注射后4周和8周评估过去24小时内的疼痛严重程度、肢体功能、最大握力时的疼痛和力量、手臂、肩部和手部功能障碍快速问卷(Quick DASH)评分、改良Nirschl评分以及压痛阈值。我们使用卡方检验和t检验分析数据。

结果

组内分析显示自体血治疗效果更好(除握力外,所有P值均<0.001,握力P = 0.005)。在皮质类固醇组中,疼痛严重程度(P = 0.008)和握力(P = 0.001)差异显著。在4周时,组间分析显示自体血在疼痛严重程度(P = 0.001)、握力疼痛(P = 0.002)、压痛阈值(P = 0.031)和Quick DASH问卷评分(P = 0.004)方面更具优势。改良Nirschl评分、握力和肢体功能方面无显著差异。在8周时,自体血在所有结果方面都更有效(所有P值均<0.001)。

结论

自体血在短期内比皮质类固醇注射更有效。

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