Itzkowitch D, Ginsberg F, Leon M, Bernard V, Appelboom T
Division of Rheumatology, Erasmus University Hospital, University of Brussels.
Clin Rheumatol. 1996 Nov;15(6):604-9. doi: 10.1007/BF02238552.
Eighty out-patients (50 F, 30 M), aged 58 +/- 12 years (range: 26-84) and weighing 72 +/- 10 kg (range: 50-97), presenting with an acute or subacute (< 3 months) episode of rotator cuff tendinitis without (n = 28) or with movement restriction (n = 52) of the shoulder and having a pain intensity of at least 4 on VAS for pain at rest or on active movement, were treated at random and in double blind conditions for 1 to 4 weeks with 1 weekly periarticular anterior injection of tenoxicam 20 mg or placebo. Tenoxicam treated patients improved more than placebo-injected patients in a statistically highly significant manner with regard to clinical index, pain on VAS during active movement and at rest, active mobility (degrees), pain or pressure and clinical global impression (assessed by investigator and patient). There was a nonsignificant opinion that placebo treated patients consumed more rescue medication. Safety assessments were not significantly better in the placebo-treated patients through local tolerability tended to be better in that group. These results indicate that tenoxicam 20 mg injected locally is effective in alleviating pain and in improving shoulder mobility in patients with a painful shoulder episode and suggest that such a treatment is safe and well tolerated. Local injection of tenoxicam seems to be a promising new treatment of acute, painful, local inflammatory processes in Rheumatology, Orthopaedics, Physical Medicine and Sports Medicine. Further studies in other pathologies are warranted.
80例门诊患者（50例女性，30例男性），年龄58±12岁（范围：26 - 84岁），体重72±10 kg（范围：50 - 97 kg），表现为急性或亚急性（<3个月）肩袖肌腱炎发作，其中28例肩部无活动受限，52例有活动受限，静息或主动活动时疼痛强度在视觉模拟评分法（VAS）上至少为4分，在随机双盲条件下接受治疗1至4周，每周1次关节周围前部注射20 mg替诺昔康或安慰剂。在临床指标、主动活动和静息时VAS疼痛评分、主动活动度（度数）、疼痛或压痛以及临床总体印象（由研究者和患者评估）方面，替诺昔康治疗的患者比注射安慰剂的患者改善更为显著，具有统计学高度显著性差异。有一种无显著差异的观点认为，安慰剂治疗的患者使用了更多的急救药物。通过局部耐受性来看，安慰剂治疗患者的安全性评估并没有显著更好，尽管该组局部耐受性往往更好。这些结果表明，局部注射20 mg替诺昔康对缓解疼痛性肩部发作患者的疼痛和改善肩部活动度有效，提示这种治疗方法安全且耐受性良好。局部注射替诺昔康似乎是风湿病学、骨科、物理医学和运动医学中急性、疼痛性局部炎症过程的一种有前景的新治疗方法。有必要对其他病症进行进一步研究。
