Petri M, Dobrow R, Neiman R, Whiting-O'Keefe Q, Seaman W E
Department of Medicine, University of California, San Francisco.
Arthritis Rheum. 1987 Sep;30(9):1040-5. doi: 10.1002/art.1780300911.
The effect of triamcinolone subacromial bursa injection versus naproxen therapy was compared in a randomized, double-blind, placebo-controlled study of 100 patients who had painful shoulders. Outcome was compared using degree of active abduction, pain, limitation of function, and a clinical index that combined equally weighted measures of all of these. In a time-adjusted analysis, triamcinolone was superior to placebo in all clinical variables. Naproxen was superior to placebo in all variables except pain. Triamcinolone was superior to naproxen in the relief of pain (P = 0.04) and the clinical index (P = 0.04). Multiple linear regression analysis showed that naproxen and triamcinolone treatment accounted for only 16% of the variation in outcome, compared with 44% accounted for by the clinical index prior to treatment. Thus, patients with a poor pretreatment clinical index (those with the most room for improvement) were least likely to improve. We conclude that both triamcinolone (P = 0.00005) and naproxen (P = 0.02) are superior to placebo in the treatment of the painful shoulder.
在一项针对100例肩部疼痛患者的随机、双盲、安慰剂对照研究中，比较了曲安奈德肩峰下滑囊注射与萘普生治疗的效果。使用主动外展程度、疼痛程度、功能受限情况以及一个综合了所有这些指标且权重相等的临床指数来比较结果。在时间调整分析中，曲安奈德在所有临床变量上均优于安慰剂。萘普生在除疼痛外的所有变量上均优于安慰剂。曲安奈德在缓解疼痛（P = 0.04）和临床指数（P = 0.04）方面优于萘普生。多元线性回归分析表明，萘普生和曲安奈德治疗仅占结果变异的16%，而治疗前临床指数占44%。因此，治疗前临床指数较差（改善空间最大）的患者改善可能性最小。我们得出结论，曲安奈德（P = 0.00005）和萘普生（P = 0.02）在治疗肩部疼痛方面均优于安慰剂。
