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冲击波疗法与皮质类固醇注射治疗外侧肱骨上髁炎:随机对照试验的荟萃分析。

Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: a meta-analysis of randomized controlled trials.

机构信息

Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.

Department of Orthopedics, Pu'ai Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.

出版信息

Phys Sportsmed. 2019 Sep;47(3):284-289. doi: 10.1080/00913847.2019.1599587. Epub 2019 Apr 5.

DOI:10.1080/00913847.2019.1599587
PMID:30951399
Abstract

: Shock-wave (SW) therapy has been widely promoted and proven to be effective in ameliorating symptoms of lateral epicondylitis (LE) during recent years. Corticosteroid (CS) injection is another common treatment of LE, and several researches have documented its significant effect in the treatment of LE. Despite this, few studies have focused on comparing the use of SW and CS in the treatment of LE. The aim of this meta-analysis is to assess whether SW is superior to CS in managing LE, both in terms of ameliorating pain and improving functionality. : A systematic search of the literature was conducted to identify relevant articles that were published in Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov and OVID from the databases' inception to December 2018. All studies comparing the efficacy of SW and CS in terms of pain levels and functionality improvement were included. Data on the two primary outcomes were collected and analyzed using the Review Manager 5.3. : Four studies were included in the current meta-analysis. A significant difference in VAS score (SMD = 1.13, Cl 0.72-1.55 P < 0.00001, I = 0) was noted between the SW group and the CS group. Furthermore, Significant difference was also seen in the term of grip strength (including HGS and GSS scoring system) (SMD = -1.42, Cl -1.85--0.98 P < 0.00001, I = 0). : In light of the better improvement in the terms of VAS and grip strength with follow-up more than 12 weeks, we assume that SW may be a superior alternative for the treatment of LE.

摘要

冲击波疗法近年来已被广泛推广并证实对改善外侧肱骨上髁炎(LE)的症状有效。皮质类固醇(CS)注射是 LE 的另一种常见治疗方法,有几项研究记录了其在 LE 治疗中的显著效果。尽管如此,很少有研究关注 SW 和 CS 在 LE 治疗中的使用比较。本荟萃分析旨在评估 SW 在缓解疼痛和改善功能方面是否优于 CS 治疗 LE。

系统地搜索了文献,以确定从数据库成立到 2018 年 12 月在 Pubmed、Medline、Embase、Cochrane Library、SpringerLink、Clinical Trials.gov 和 OVID 上发表的相关文章。所有比较 SW 和 CS 在疼痛水平和功能改善方面疗效的研究都被纳入。使用 Review Manager 5.3 收集和分析了两个主要结果的数据。

当前的荟萃分析包括四项研究。SW 组和 CS 组之间的 VAS 评分(SMD = 1.13,Cl 0.72-1.55 P < 0.00001,I = 0)有显著差异。此外,在握力方面(包括 HGS 和 GSS 评分系统)也有显著差异(SMD = -1.42,Cl -1.85--0.98 P < 0.00001,I = 0)。

鉴于在 VAS 和握力方面的改善在随访超过 12 周时更好,我们假设 SW 可能是治疗 LE 的更好选择。

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