Talke M
Handchir Mikrochir Plast Chir. 1984 Mar;16(1):59-63.
The use of intra-articular corticosteroid therapy during the acute stage of arthritis is widely accepted. The symmetric involvement in both hands of identical finger joints is the ideal basis for a comparative study of the efficiency of such injections. In a randomized trial corticoid was directly compared with Orgotein, the enzyme "Superoxid-Dismutase" which inactivates oxygen-combinations and thereby interrupts inflammatory reactions. In this way accepted treatment of both sides was possible without the use of a placebo which could be considered as doubtful for ethical reasons. The results were evaluated using the following three reproducible parameters: 1. joint diameter before and after treatment 2. strength of pinch-grip 3. range of motion. Thirty-one patients with ninety-eight affected joints were treated and followed up. Thirty patients showed an improvement upon both treatments. Twenty-six of them reported identical pain relief for the corticoid and Orgotein treated joint on both sides after approximately three injections per finger joint. In four cases pain relief in the Orgotein treated joints was less significant than in the corticoid treated ones.
在关节炎急性期使用关节内皮质类固醇疗法已被广泛接受。双手相同手指关节的对称性受累是比较此类注射疗效的理想基础。在一项随机试验中，将皮质类固醇与奥古蛋白直接进行比较，奥古蛋白是一种“超氧化物歧化酶”，能使氧结合失活，从而中断炎症反应。通过这种方式，无需使用因伦理原因可能存疑的安慰剂，就可以对两侧进行公认的治疗。使用以下三个可重复参数对结果进行评估：1. 治疗前后的关节直径；2. 捏握力；3. 活动范围。对31例患者的98个受累关节进行了治疗和随访。30例患者在两种治疗后均有改善。其中26例报告称，在每个手指关节大约注射三次后，两侧经皮质类固醇和奥古蛋白治疗的关节疼痛缓解程度相同。在4例患者中，奥古蛋白治疗关节的疼痛缓解程度不如皮质类固醇治疗的关节明显。
