Eulry F, Aczel F, Vasseur P, Thomas E, Pattin S, Doury P
Service de Rhumatologie, Hôpital d'Instruction des Armées Bégin, Saint-Mandé.
Ann Med Interne (Paris). 1990;141(1):20-5.
This retrospective review presents the results of treating 199 patients with sympathetic reflex dystrophy of the foot: 141 of traumatic and 58 of non-traumatic origin. Calcitonin (177 patients) improved or cured 62.2 p. 100 of these patients and was equally effective for pseudo inflammatory and ischemic (cold) stages of the disease. Among the therapeutic means available, regional sympathetic blockade with guanethidine (49 patients, 163 treatments) provided 80 p. 100 improvement or cure, with twice as many patients in the hot phase as in the cold. All patients were cured: 75 p. 100 in less than a year, 4.6 p. 100 with moderate, non-handicapping sequelae. Normal activities were partially reinstituted 3.5 +/- 2.8 months (post-trauma) or 1.9 +/- 1 months (non-trauma) after treatment. They were completely possible 5 months after the end of treatment in both groups. In the trauma group, 73 patients had work-related accidents: their evolution was the same as that of the other patients in this group. When present, psychological background (35 p. 100 of the cases) only delayed progress in the non-traumatic group (9.9 vs 6.5 months).
这项回顾性研究展示了对199例足部交感反射性营养不良患者的治疗结果：其中141例为创伤性病因，58例为非创伤性病因。降钙素（177例患者）使其中62.2%的患者病情得到改善或治愈，并且对疾病的假炎症期和缺血（寒冷）期同样有效。在现有的治疗手段中，胍乙啶区域交感神经阻滞（49例患者，共进行163次治疗）使80%的患者病情得到改善或治愈，其中处于发热期的患者数量是寒冷期的两倍。所有患者均被治愈：75%的患者在不到一年的时间内治愈，4.6%的患者留有中度、不影响生活的后遗症。治疗后，创伤后组患者在3.5±2.8个月后、非创伤组患者在1.9±1个月后部分恢复正常活动。两组患者在治疗结束5个月后均可完全恢复正常活动。在创伤组中，73例患者发生了与工作相关的事故：他们的病情发展与该组其他患者相同。在非创伤组中，存在心理背景因素（占病例的35%）时只会延迟病情进展（9.9个月对6.5个月）。
