Kaya Samet Sancar, Yardımcı Gökhan, Göksu Hamit, Genç Hakan
Department of Algology, Ankara City Hospital, Ankara, Türkiye.
Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye.
Turk J Phys Med Rehabil. 2022 Jun 1;68(2):205-213. doi: 10.5606/tftrd.2022.8007. eCollection 2022 Jun.
This study aims to compare the efficacy of the wrist splint and the injection of corticosteroid, autologous blood, and hypertonic dextrose in the treatment of lateral epicondylitis (LE).
A total of 120 patients (43 males, 77 females; mean age: 45.7±7.7 years; range, 18 to 65 years) diagnosed with LE between December 2013 and June 2015 were included in the study and randomized into four groups. The first group was administered 20 mg methylprednisolone acetate + 2 mL 2% prilocaine, the second group 2 mL venous blood + 0.5 mL prilocaine, and the third group 2 mL 30% dextrose + 0.5 mL prilocaine injections. A second injection was administered to the third group one month later. The fourth group was recommended to use only a wrist splint. Pre-treatment and post-treatment evaluations of the patients were carried out at one and six months by the Visual Analog Scale (VAS) in terms of pain, by Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire in terms of functional level, and by the Jamar dynamometer in terms of grip strength.
In all groups, VAS values at one and six months after treatment were found to be lower in comparison to baseline. Except for the splint group, a significant improvement was observed in all three injection groups in terms of grip strength and PRTEE values at six months compared to the baseline values. In the comparison of the groups, no significant difference was observed in terms of improvement in VAS scores and grip strength. While corticosteroid injection was significantly effective in terms of PRTEE pain, function, and total scores only at one month, the autologous injection was effective in terms of PRTEE function and total scores at only six months after treatment. There were no significant differences for splint and prolotherapy groups in terms of PRTEE scores.
Corticosteroid injection, autologous blood injection, and prolotherapy are effective and safe long-term methods in LE treatment.
本研究旨在比较腕部夹板与注射皮质类固醇、自体血和高渗葡萄糖治疗外侧 epicondylitis（LE）的疗效。
2013 年 12 月至 2015 年 6 月期间诊断为 LE 的 120 例患者（43 例男性，77 例女性；平均年龄：45.7±7.7 岁；范围 18 至 65 岁）纳入本研究并随机分为四组。第一组给予 20mg 醋酸甲泼尼龙 + 2mL 2% 丙胺卡因，第二组给予 2mL 静脉血 + 0.5mL 丙胺卡因，第三组给予 2mL 30% 葡萄糖 + 0.5mL 丙胺卡因注射。第三组在 1 个月后进行第二次注射。第四组仅建议使用腕部夹板。在 1 个月和 6 个月时通过视觉模拟量表（VAS）评估患者的疼痛情况，通过患者评定网球肘评估（PRTEE）问卷评估功能水平，通过 Jamar 握力计评估握力，进行治疗前和治疗后的评估。
在所有组中，治疗后 1 个月和 6 个月时的 VAS 值均低于基线值。除夹板组外，所有三个注射组在 6 个月时的握力和 PRTEE 值与基线值相比均有显著改善。在组间比较中，VAS 评分和握力改善方面未观察到显著差异。虽然皮质类固醇注射仅在 1 个月时对 PRTEE 疼痛、功能和总分有显著效果，但自体血注射仅在治疗后 6 个月时对 PRTEE 功能和总分有效。夹板组和注射治疗组在 PRTEE 评分方面无显著差异。
皮质类固醇注射、自体血注射和注射治疗是治疗 LE 的有效且安全的长期方法。
