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肌肉注射糖皮质激素治疗腰椎神经根性疼痛患者的疗效:一项随机对照试验。

Efficacy of intramuscular glucocorticoid injection in patients with lumbar radicular pain: a randomized controlled trial.

作者信息

Boga Vijdan Ezgi, Basaran Sibel, Balal Mehmet

机构信息

Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Cukurova University, Adana, 01330, Türkiye.

Faculty of Medicine, Department of Neurology, Cukurova University, Adana, Türkiye.

出版信息

BMC Musculoskelet Disord. 2025 Jul 4;26(1):650. doi: 10.1186/s12891-025-08897-1.


DOI:10.1186/s12891-025-08897-1
PMID:40616084
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12228230/
Abstract

BACKGROUND: Although glucocorticoid therapy has been used in patients with lumbar radiculopathy for many years, the results of studies in literature are inconsistent. The aim of the study was to evaluate the effects of intramuscular betamethasone injection on pain, disability, quality of life and electroneuromyography (ENMG) findings in patients with lumbar radicular pain (LRP). METHODS: Patients with LRP (n = 98) were evaluated between July 2022 and June 2023. Sixty patients who met the inclusion criteria were randomized into two groups. Glucocorticoid group (GC) received intramuscular injection of betamethasone and Placebo group (PB) received isotonic sodium chloride. Visual analog scale (VAS), Oswestry disability index (ODI), Nottingham health profile (NHP) and ENMG were applied to both groups. Patients were evaluated before treatment and after first week, first month and third month of treatment. RESULTS: Significant improvements were seen in all clinical parameters in GC group. At the end of third month, VAS and NHP-Pain subscale scores improved significantly in both groups (p < 0.001) but the change of these values over time was statistically significant in favor of GC group (p = 0.03 and p = 0.044, respectively). The significant improvements observed in ODI, Energy and Physical Mobility subscales and Total scores of NHP in both groups (p < 0.05) revealed no significant difference between the groups over time. The ENMG data revealed no significant difference within the groups except the fibrillation potentials, which disappeared in both groups. CONCLUSION: Intramuscular glucocorticoid administration provided improvements on pain, disability and quality of life of patients with LRP. Especially the effects on pain scores were superior to placebo. No superiority over placebo on ENMG findings has been demonstrated and further studies are needed in this regard. CLINICAL TRIAL REGISTRATION: The study protocol was registered to Clinicaltrials.gov with the number NCT05571046 (retrospectively registered on 30/09/2022).

摘要

背景:尽管糖皮质激素疗法已在腰椎神经根病患者中使用多年,但文献研究结果并不一致。本研究的目的是评估肌肉注射倍他米松对腰椎神经根性疼痛(LRP)患者的疼痛、功能障碍、生活质量和神经肌电图(ENMG)结果的影响。 方法:在2022年7月至2023年6月期间对LRP患者(n = 98)进行评估。将符合纳入标准的60名患者随机分为两组。糖皮质激素组(GC)接受肌肉注射倍他米松,安慰剂组(PB)接受等渗氯化钠。两组均应用视觉模拟量表(VAS)、奥斯威斯利功能障碍指数(ODI)、诺丁汉健康量表(NHP)和ENMG。在治疗前以及治疗第一周、第一个月和第三个月后对患者进行评估。 结果:GC组所有临床参数均有显著改善。在第三个月末,两组的VAS和NHP疼痛子量表评分均显著改善(p < 0.001),但这些值随时间的变化在GC组中具有统计学意义(分别为p = 0.03和p = 0.044)。两组在ODI、能量和身体活动子量表以及NHP总分方面观察到的显著改善(p < 0.05)表明,随时间推移两组之间无显著差异。ENMG数据显示,除了两组中均消失的纤颤电位外,组内无显著差异。 结论:肌肉注射糖皮质激素可改善LRP患者的疼痛、功能障碍和生活质量。尤其是对疼痛评分的影响优于安慰剂。在ENMG结果方面未显示出优于安慰剂的效果,因此在这方面需要进一步研究。 临床试验注册:该研究方案已在Clinicaltrials.gov上注册,编号为NCT05571046(于2022年9月30日追溯注册)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/6a1e0d873225/12891_2025_8897_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/d9acf365dc36/12891_2025_8897_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/d77030323a2c/12891_2025_8897_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/0e1708ece031/12891_2025_8897_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/8f2772ee71a0/12891_2025_8897_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/6a1e0d873225/12891_2025_8897_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/d9acf365dc36/12891_2025_8897_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/d77030323a2c/12891_2025_8897_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/0e1708ece031/12891_2025_8897_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/8f2772ee71a0/12891_2025_8897_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78b/12228230/6a1e0d873225/12891_2025_8897_Fig5_HTML.jpg

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Efficacy of intramuscular glucocorticoid injection in patients with lumbar radicular pain: a randomized controlled trial.

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本文引用的文献

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Eur J Phys Rehabil Med. 2024-4

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Pain Pract. 2024-3

[3]
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Cochrane Database Syst Rev. 2022-10-21

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Pain Physician. 2021-8

[5]
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Cureus. 2019-10-17

[6]
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Medicina (Kaunas). 2019-11-14

[7]
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Clinics (Sao Paulo). 2019-10-28

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BMC Musculoskelet Disord. 2019-5-22

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Curr Pain Headache Rep. 2019-3-11

[10]
Short-term Efficiency and Tolerance of Ketoprofen and Methylprednisolone in Acute Sciatica: A Randomized Trial.

Pain Med. 2019-7-1

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