Department of Rheumatology, Musgrave Park Hospital, and Centre for Public Health, Queens' University Belfast, Belfast, UK.
Ann Rheum Dis. 2013 Jun;72(6):996-1002. doi: 10.1136/annrheumdis-2012-201508. Epub 2012 Jun 27.
Plantar fasciitis is a common cause of heel pain. The aim of this study was twofold: to compare steroid injection with placebo injection and to compare ultrasound guided with unguided steroid injection in the management of this condition.
65 patients with inferior heel pain were recruited between November 2008 and June 2011. Heel pain was measured using a visual analogue scale (VAS) at baseline and follow-up 6 and 12 weeks after injection.
22 patients were randomised to ultrasound guided steroid injection, 21 patients to palpation guided steroid injection and 22 to ultrasound guided placebo injection. There was a significant difference in VAS scores between the groups at 6 and 12 weeks (p=0.018 and p=0.004, respectively). There was a 19.7 (95% CI 2.5 to 37.0) difference in mean VAS scores at 6 weeks between the ultrasound guided steroid group and the placebo group and a 24.0 (95% CI 6.6 to 41.3) difference between the unguided steroid group and the placebo group at 6 weeks. At 12 weeks, the mean difference was 25.1 (95% CI 6.5 to 43.6) and 28.4 (95% CI 11.1 to 45.7) respectively between both steroid injection groups and the placebo group. There was no difference in VAS scores following steroid injection between the ultrasound guided and the unguided groups at either time point. Plantar fascia thickness was significantly reduced after injection in both active treatment groups (p=0.00).
In this study, steroid injection showed a clear benefit over placebo at 6 weeks and this difference was maintained at 12 weeks. Trial Registration No ISRCTN79628180 (www.controlled-trials.com).
足底筋膜炎是足跟痛的常见病因。本研究旨在比较类固醇注射与安慰剂注射的效果，以及超声引导与非超声引导的类固醇注射在该病症管理中的效果。
2008 年 11 月至 2011 年 6 月期间共招募了 65 例患有足跟疼痛的患者。在基线和注射后 6 周和 12 周时，使用视觉模拟量表（VAS）来测量足跟疼痛程度。
22 例患者被随机分配至超声引导下类固醇注射组，21 例患者被分配至触诊引导下类固醇注射组，22 例患者被分配至超声引导下安慰剂注射组。在 6 周和 12 周时，各组间 VAS 评分差异具有统计学意义（p=0.018 和 p=0.004）。在 6 周时，超声引导下类固醇注射组与安慰剂组之间 VAS 评分的平均差值为 19.7（95%CI 2.5 至 37.0），触诊引导下类固醇组与安慰剂组之间 VAS 评分的平均差值为 24.0（95%CI 6.6 至 41.3）。在 12 周时，两组类固醇注射组与安慰剂组之间的平均差值分别为 25.1（95%CI 6.5 至 43.6）和 28.4（95%CI 11.1 至 45.7）。在两个时间点，超声引导组与非超声引导组之间的类固醇注射后 VAS 评分均无差异。在两组活性治疗组中，注射后足底筋膜厚度均显著降低（p=0.00）。
在本研究中，类固醇注射在 6 周时明显优于安慰剂，且这种差异在 12 周时仍保持。试验注册号：ISRCTN79628180（www.controlled-trials.com）。
