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降钙素对肩周炎的影响。

Calcitonin effects on shoulder adhesive capsulitis.

作者信息

Rouhani Alireza, Mardani-Kivi Mohsen, Bazavar Mohammadreza, Barzgar Mahmood, Tabrizi Ali, Hashemi-Motlagh Keyvan, Saheb-Ekhtiari Khashayar

机构信息

Orthopedic Department of Tabriz University of Medical Sciences, Tabriz, Iran.

Poursina Hospital, Orthopedic Department of Guilan University of Medical Sciences, Parastar Ave., Rasht, Iran.

出版信息

Eur J Orthop Surg Traumatol. 2016 Aug;26(6):575-80. doi: 10.1007/s00590-016-1816-5. Epub 2016 Jul 8.

Abstract

INTRODUCTION

Adhesive capsulitis (frozen shoulder) is a relatively prevalent disease of shoulder and affects soft tissue of glenohumeral joint. Signs include painful restricted motion and disability of the patient in daily activities. Calcitonin is a thyroid hormone, and its effectiveness has been demonstrated in painful conditions. The presents study aims to evaluate the effect of calcitonin in treating shoulder adhesive capsulitis.

METHOD

This double-blinded randomized clinical trial was conducted on 64 patients suffering from shoulder adhesive capsulitis. The intervention and control groups were given intranasal calcitonin and placebo for 6 weeks, respectively. For both groups, physiotherapy and non-steroidal anti-inflammatory drugs were administered correspondingly. The patients were evaluated pre- and post-treatment for shoulder pain and shoulder range of motion (ROM). Shoulder functional outcome (secondary outcome) was evaluated using Disability of Arm, Shoulder, and Hand, Shoulder Pain and Disability Index, and Health Assessment Questionnaire disability criteria.

RESULTS

The mean age of patients in calcitonin and control group was 52.4 ± 4.6 and 53.2 ± 4.9, respectively. Demographic characteristics and pre-treatment scores were similar in both groups (all P > 0.05). In post-treatment follow-up, shoulder pain, ROM, and the patients' functional scores were significantly improved in both groups (P < 0.001); however, the improvement in calcitonin group was more effective than that of placebo group.

CONCLUSION

Intranasal calcitonin spray could be an additional safe alternative in shoulder adhesive capsulitis with regard to the efficiency in alleviating pain and improving functional outcome.

LEVEL OF EVIDENCE

II.

摘要

引言

粘连性关节囊炎(肩周炎)是一种较为常见的肩部疾病,会影响肱盂关节的软组织。症状包括疼痛导致的活动受限以及患者日常生活能力丧失。降钙素是一种甲状腺激素,其在疼痛性疾病中的疗效已得到证实。本研究旨在评估降钙素治疗肩部粘连性关节囊炎的效果。

方法

本双盲随机临床试验对64例肩部粘连性关节囊炎患者进行。干预组和对照组分别给予鼻内降钙素和安慰剂,为期6周。两组均相应给予物理治疗和非甾体类抗炎药。在治疗前后对患者的肩部疼痛和肩部活动范围(ROM)进行评估。使用手臂、肩部和手部功能障碍、肩部疼痛和功能障碍指数以及健康评估问卷残疾标准评估肩部功能结局(次要结局)。

结果

降钙素组和对照组患者的平均年龄分别为52.4±4.6岁和53.2±4.9岁。两组的人口统计学特征和治疗前评分相似(所有P>0.05)。在治疗后的随访中,两组的肩部疼痛、ROM和患者功能评分均显著改善(P<0.001);然而,降钙素组的改善比安慰剂组更有效。

结论

就缓解疼痛和改善功能结局的效率而言,鼻内降钙素喷雾剂可能是肩部粘连性关节囊炎的一种额外安全的治疗选择。

证据级别

II级。

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