Mi Bobin, Liu Guohui, Zhou Wu, Lv Huijuan, Liu Yi, Wu Qipeng, Liu Jing
a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
b Department of Rheumatology , Tangdu Hospital, The Fourth Military Medical University , Xi'an , China.
Phys Sportsmed. 2017 May;45(2):97-104. doi: 10.1080/00913847.2017.1297670. Epub 2017 Mar 3.
Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE.
A systematic search of the literature was conducted to identify related articles published from January 1980 to September 2016 in Pubmed, Embase, the Cochrane Library and SpringerLink. All studies that compared PRP with steroid administration on LE were included. Main outcomes were collected and analyzed by the Review Manager 5.1.
Eight randomized controlled trials (RCTs) that involved 511 patients met the criteria. This meta-analysis showed that there was no significant difference in pain relief in the short-term (2 to 4 weeks: SMD = 1.02, P = .03; 6 to 8 weeks: SMD = .73, P = .24) and the intermediate-term (12 weeks: SMD = -0.28, P = .35). Steroid exhibited a better efficacy of function in the short-term (2 to 4 weeks: SMD = .61, P < .001; 6 to 8 weeks: SMD = .53, P < .001). However, PRP was superior to steroid for pain relief in the long-term (half year: SMD = -1.6, P < .001; one year: SMD = -1.45, P < .001), and also for function improving in the intermediate-term (12 weeks: SMD = -0.53, P < .001) and the long-term (half year: SMD = -0.56, P < .001; one year: SMD = -0.7, P < .001). No serious adverse effects of treatment were observed in the two groups.
Treatment of patients with LE by steroid could slightly relieve pain and significantly improve function of elbow in the short-term (2 to 4 weeks, 6 to 8 weeks). PRP appears to be more effective in relieving pain and improving function in the intermediate-term (12 weeks) and long-term (half year and one year). Considering the long-term effectiveness of PRP, we recommend PRP as the preferred option for LE.
外侧上髁炎（LE）是一种常见的肌腱病，目前仍未知其有效治疗方法。本荟萃分析的目的是比较富血小板血浆（PRP）与类固醇在减轻LE患者肘部疼痛和改善功能方面的有效性。
对文献进行系统检索，以确定1980年1月至2016年9月在Pubmed、Embase、Cochrane图书馆和SpringerLink上发表的相关文章。纳入所有比较PRP与类固醇治疗LE的研究。主要结局由Review Manager 5.1收集和分析。
八项涉及511例患者的随机对照试验（RCT）符合标准。本荟萃分析表明，短期（2至4周：标准化均数差[SMD]=1.02，P=0.03；6至8周：SMD=0.73，P=0.24）和中期（12周：SMD=-0.28，P=0.35）疼痛缓解方面无显著差异。类固醇在短期（2至4周：SMD=0.61，P<0.001；6至8周：SMD=0.53，P<0.001）功能改善方面疗效更好。然而，PRP在长期（半年：SMD=-1.6，P<0.001；一年：SMD=-1.45，P<0.001）疼痛缓解方面优于类固醇，在中期（12周：SMD=-0.53，P<0.001）和长期（半年：SMD=-0.56，P<0.001；一年：SMD=-0.7，P<0.001）功能改善方面也优于类固醇。两组均未观察到严重的治疗不良反应。
类固醇治疗LE患者可在短期（2至4周、6至8周）轻微缓解疼痛并显著改善肘部功能。PRP在中期（12周）和长期（半年和一年）缓解疼痛和改善功能方面似乎更有效。考虑到PRP的长期有效性，我们推荐PRP作为LE的首选治疗方案。
