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大转子疼痛综合征的治疗:系统评价。

Management of the greater trochanteric pain syndrome: a systematic review.

机构信息

Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Italy.

出版信息

Br Med Bull. 2012 Jun;102:115-31. doi: 10.1093/bmb/ldr038. Epub 2011 Sep 4.

Abstract

INTRODUCTION

Greater trochanteric pain syndrome (GTPS) is a debilitating condition characterized by lateral hip pain located at or around the greater trochanter.

SOURCE OF DATA

We performed a comprehensive search of Pubmed, Medline, Ovid, Google Scholar and Embase databases, from inception of the database to 20th of June 2011, using a variety of keywords. We identified 52 relevant abstracts of articles published in peer-reviewed journals. Fourteen studies reporting the outcomes of patients undergoing conservative and surgical management of GTPS were selected.

AREAS OF AGREEMENT

Significant pain relief and improved outcomes were observed after conservative and surgical management of GTPS. The modified Coleman methodology score averaged 44.7 (range from 14 to 82), evidencing an overall low-to-moderate quality of the studies. Repetitive low-energy radial shock wave therapy and home training approach provide beneficial effect over months, with almost 80% success rate at 15 months.

AREAS OF CONTROVERSY

Poor available data extracted from small studies do not allow definitive conclusions to be drawn on the best treatment for GTPS.

GROWING POINTS

Further multi-centre prospective studies are necessary to confirm the general validity of the findings reported.

AREAS TIMELY FOR DEVELOPING RESEARCH

Future research and trials should focus on the application and effectiveness of the various conservative modalities for management of GTPS.

CONCLUSION

The effectiveness of the various treatment modalities needs to be tested in carefully conducted randomized controlled trials.

摘要

引言

大转子疼痛综合征(GTPS)是一种使人衰弱的病症,其特征为位于或围绕大转子的臀部外侧疼痛。

资料来源

我们在 Pubmed、Medline、Ovid、Google Scholar 和 Embase 数据库中进行了全面检索,检索时间从数据库建立到 2011 年 6 月 20 日,使用了多种关键词。我们共识别出 52 篇相关的同行评审期刊文章的摘要。选择了 14 项报告 GTPS 患者接受保守和手术治疗结果的研究。

共识领域

GTPS 经保守和手术治疗后,疼痛明显缓解,结果改善。改良的 Coleman 方法评分平均为 44.7(范围从 14 到 82),这表明研究的整体质量为低到中度。重复低能量径向冲击波治疗和家庭训练方法在数月内提供有益的效果,在 15 个月时成功率接近 80%。

争议领域

从小规模研究中提取的可用数据不佳,无法就 GTPS 的最佳治疗方法得出明确的结论。

研究发展的增长点

需要进一步进行多中心前瞻性研究,以确认所报告发现的普遍有效性。

及时研究领域

未来的研究和试验应集中在管理 GTPS 的各种保守方式的应用和有效性上。

结论

各种治疗方式的有效性需要在精心设计的随机对照试验中进行测试。

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