Smith D L, McAfee J H, Lucas L M, Kumar K L, Romney D M
Department of Medicine, Oregon Health Sciences University, Portland.
Arch Intern Med. 1989 Nov;149(11):2527-30.
We enrolled 42 patients with nonseptic olecranon bursitis in a double-blind prospective treatment trial to compare the efficacy of an intrabursal steroid preparation with that of an oral anti-inflammatory agent. Patients were randomized into one of four treatment regimens: (1) methylprednisolone acetate (20 mg) intrabursal injection and oral naproxen (1 g/d for 10 days), (2) methylprednisolone acetate (20 mg) intrabursal injection and oral placebo for 10 days, (3) oral naproxen (1 g/d for 10 days), and (4) oral placebo for 10 days. The degree of swelling in millimeters was assessed at study introduction and at 1, 3, and 6 weeks. At 6 months, the number of patients requiring reaspiration for bursitis recurrence was tabulated. Data at 1 week indicated that patients treated with an intrabursal methylprednisolone acetate injection (20 mg) demonstrated the most rapid decrease in swelling. At 6 weeks, the methylprednisolone-treated groups demonstrated sustained improvement. At 6 months, the mean number of reaspirations per patient for reaccumulation of bursal fluid was higher in groups 3 (1.0 +/- 1.2) and 4 (0.4 +/- 0.7). An intrabursal methylprednisolone acetate 20-mg injection seems to be the most effective treatment regimen for nonseptic olecranon bursitis.
我们招募了42例非感染性鹰嘴滑囊炎患者，进行一项双盲前瞻性治疗试验，以比较滑囊内注射类固醇制剂与口服抗炎药的疗效。患者被随机分为四种治疗方案之一：（1）醋酸甲泼尼龙（20 mg）滑囊内注射加口服萘普生（1 g/d，共10天），（2）醋酸甲泼尼龙（20 mg）滑囊内注射加口服安慰剂10天，（3）口服萘普生（1 g/d，共10天），（4）口服安慰剂10天。在研究开始时以及第1、3和6周评估肿胀程度（以毫米为单位）。在6个月时，将因滑囊炎复发而需要再次抽吸的患者数量制成表格。1周时的数据表明，接受醋酸甲泼尼龙滑囊内注射（20 mg）治疗的患者肿胀消退最快。在6周时，甲泼尼龙治疗组显示出持续改善。在6个月时，第3组（1.0±1.2）和第4组（0.4±0.7）患者因滑囊积液再次抽吸的平均次数较高。20 mg醋酸甲泼尼龙滑囊内注射似乎是非感染性鹰嘴滑囊炎最有效的治疗方案。
