Vukelic Brian, Abbey Rebecca, Knox Jordan, Migdalski Alyssa
University of Utah Family Medicine Division, Salt Lake City.
Schusterman Library, University of Oklahoma, Tulsa.
J Fam Pract. 2021 Nov;70(9):461-463. doi: 10.12788/jfp.0308.
Placebo injections actually improve lateral epicondylitis at high rates. No other injections convincingly improve it better than placebo.Corticosteroid injection is not superior to saline or anesthetic injection (strength of recommendation [SOR] A, systematic review of randomized controlled trials [RCTs]). Platelet-rich plasma (PRP) injection is not superior to saline injection (SOR A, meta-analysis of RCTs).Botulinum toxin injection, compared to saline injection, modestly improved pain in lateral epicondylitis, but with short-term grip-strength weakness (SOR A, meta-analysis of RCTs). Prolotherapy injection, compared to saline injection, improved pain at 16-week, but not at 8-week, follow-up (SOR B, one small pilot RCT).Hyaluronic acid injection, compared to saline injection, resulted in a statistically significant pain reduction (6%) but did not achieve the minimum clinically important difference (SOR B, single RCT).Autologous blood injection, compared to saline injection, did not improve disability ratings (SOR B, one small RCT).
安慰剂注射实际上能以较高比例改善肱骨外上髁炎。没有其他注射方法能比安慰剂更令人信服地改善病情。皮质类固醇注射并不优于生理盐水或麻醉剂注射（推荐强度[SOR] A，随机对照试验[RCT]的系统评价）。富血小板血浆（PRP）注射并不优于生理盐水注射（SOR A，RCT的荟萃分析）。与生理盐水注射相比，肉毒杆菌毒素注射能适度改善肱骨外上髁炎的疼痛，但会导致短期握力减弱（SOR A，RCT的荟萃分析）。与生理盐水注射相比，注射疗法在16周随访时改善了疼痛，但在8周随访时没有（SOR B，一项小型先导RCT）。与生理盐水注射相比，透明质酸注射导致疼痛有统计学意义的减轻（6%），但未达到最小临床重要差异（SOR B，单项RCT）。与生理盐水注射相比，自体血注射并未改善残疾评定（SOR B，一项小型RCT）。
