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比较皮质类固醇、干针和 PRP 应用在外侧肱骨上髁炎中的疗效。

Comparison of the efficacy of corticosteroid, dry needling, and PRP application in lateral epicondylitis.

机构信息

Department of Orthopedic and Traumatology, Batman Training and Research Hospital, Batman, Turkey.

Department of Physical Medicine and Rehabilitation, Batman Training and Research Hospital, Batman, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2022 Dec;32(8):1569-1575. doi: 10.1007/s00590-021-03138-2. Epub 2021 Oct 6.

Abstract

PURPOSE

The aim of this study was to compare the short-term efficacy of dry needling, corticosteroids, and platelet-rich plasma application (PRP) in the management of lateral epicondylitis.

METHODS

The study included 72 patients diagnosed with lateral epicondylitis divided into three groups of 24 individuals using the sealed envelope method. Group 1 underwent dry needling, Group 2 received 40 mg methylprednisolone acetate, and Group 3 received PRP treatment. Patients were assessed using the visual analog scale (VAS) and the Disabilities of the Shoulder, Arm, and Hand (DASH) score, and Jamar grip strength before treatment and 3rd week and 3rd month.

RESULTS

At the 3rd month, the mean VAS score was 1.16 ± 0.56 in dry needling group and 0.75 ± 0.60 in corticosteroids group, showing a statistically significant difference between dry needling and corticosteroids group, and between corticosteroids and PRP group (p = 0.015 and p = 0.000, respectively). At the 3rd week and 3rd month, VAS scores decreased in each treatment modality group, showing a statistically significant difference between the groups (p < 0.01). Jamar grip strength increased over time in all groups. There were no significant differences between the DASH scores of all groups at the 3rd week (p > 0.05). DASH scores decreased significantly from the 3rd week to the 3rd month in dry needling and corticosteroids group (p < 0.01), while it increased slightly in PRP group during the same period with a statistically insignificant change (p > 0.05). DASH scores decreased significantly at the 3rd month for all groups (p = 0.014).

CONCLUSION

Dry needling is an effective and safe application for the short-term treatment of lateral epicondylitis.

摘要

目的

本研究旨在比较干针、皮质类固醇和富含血小板的血浆(PRP)应用在治疗外侧肱骨上髁炎中的短期疗效。

方法

该研究纳入了 72 例外侧肱骨上髁炎患者,采用密封信封法分为 3 组,每组 24 例。第 1 组接受干针治疗,第 2 组接受 40mg 醋酸甲泼尼龙治疗,第 3 组接受 PRP 治疗。患者在治疗前、第 3 周和第 3 个月分别采用视觉模拟评分(VAS)和肩臂手残疾问卷(DASH)评分和 Jamar 握力计进行评估。

结果

在第 3 个月时,干针组的平均 VAS 评分为 1.16±0.56,皮质类固醇组为 0.75±0.60,干针组与皮质类固醇组之间、皮质类固醇组与 PRP 组之间的差异均有统计学意义(p=0.015 和 p=0.000)。在第 3 周和第 3 个月时,各治疗组的 VAS 评分均降低,组间差异有统计学意义(p<0.01)。所有组的 Jamar 握力均随时间增加。第 3 周时,各组的 DASH 评分无显著差异(p>0.05)。干针组和皮质类固醇组的 DASH 评分从第 3 周到第 3 个月显著降低(p<0.01),而 PRP 组在同一时期略有升高,差异无统计学意义(p>0.05)。所有组在第 3 个月时的 DASH 评分均显著降低(p=0.014)。

结论

干针治疗是治疗外侧肱骨上髁炎的一种有效且安全的应用方法。

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