Żyluk Andrzej, Puchalski Piotr
Department of General and Hand Surgery, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland.
Neurol Neurochir Pol. 2018 May-Jun;52(3):326-333. doi: 10.1016/j.pjnns.2018.03.001. Epub 2018 Mar 12.
Complex regional pain syndrome (CRPS) is a descriptive term for a complex of symptoms and signs typically occurring following trauma of the extremity. Typical symptomatology includes severe pain, swelling, vasomotor instability and functional impairment of the affected limb. At present there is no one, effective method of treatment of the condition. A large number of treatments have been investigated but major multicentre randomized controlled trials are lacking. This study presents the results of a systematic review of the evidence on effectiveness of treatment methods in CRPS. It is a follow-up to earlier reviews of randomized controlled trials on CRPS treatment published between 1966 and 2016.
The review of randomized controlled trials showed that only bisphosphonates were found to give uniformly positive effects, statistically significantly better than placebo. Improvement has been reported with topical dimethyl sulfoxide, systemic steroids, spinal cord stimulation and graded motor imagery/mirror therapy programmes. The available evidence does not support the use of other treatments in CRPS, however they are frequently used in clinical practice.
Available evidence, although numerous, does not necessarily reflect what is truly effective and what is sham in the management of CRPS.
复杂性区域疼痛综合征（CRPS）是一个用于描述通常在肢体创伤后出现的一系列症状和体征的术语。典型症状包括严重疼痛、肿胀、血管运动不稳定以及患肢功能障碍。目前，尚无一种有效的治疗该病症的方法。已经对大量治疗方法进行了研究，但缺乏大型多中心随机对照试验。本研究展示了对CRPS治疗方法有效性证据的系统评价结果。它是对1966年至2016年间发表的关于CRPS治疗的随机对照试验早期综述的后续研究。
对随机对照试验的综述表明，仅发现双膦酸盐具有一致的积极效果，在统计学上显著优于安慰剂。据报道，局部使用二甲亚砜、全身使用类固醇、脊髓刺激以及分级运动想象/镜像疗法方案也有改善效果。现有证据不支持在CRPS中使用其他治疗方法，然而它们在临床实践中却经常被使用。
现有证据虽然众多，但不一定能反映在CRPS管理中真正有效的方法和虚假的方法。
