皮质类固醇注射,物理治疗,或等待和观察政策的侧面表炎:一个随机对照试验
Nynke Smidt1, Daniëlle A W M van der Windt, Willem J J Assendelft
1Institute for Research in Extramural Medicine, Faculty of Medicine, VU University Medical Centre, 1081 BT Amsterdam, Netherlands. n.smidt.emgo@med.vu.nl
Lancet (London, England)
|March 7, 2002
概括
皮质类固醇注射为侧面表皮质炎提供短期缓解,但物理治疗显示出优越的长期有效性. 患者在选择治疗肘部疼痛时应考虑这些因素.
科学领域:
- 整形外科 整形外科 整形外科
- 运动医学 运动医学
- 物理疗法物理治疗
背景情况:
- 侧面表皮质炎通常用皮质类固醇注射或物理治疗来治疗.
- 荷兰的临床指导方针建议在管理侧面表皮炎时采取等待和观察的方法.
研究的目的:
- 为了比较皮质类固醇注射,物理治疗和侧面表皮炎的等待政策的疗效.
- 评估不同治疗策略的短期和长期结果.
主要方法:
- 185名患有侧面表皮球炎的患者被随机分配给6周的治疗.
- 治疗包括皮质类固醇注射,物理治疗或等待政策.
- 评估的结果包括在多个时间点 (长达52周) 的总体改善,疼痛,残疾和患者满意度.
主要成果:
- 在6周,皮质类固醇注射的成功率 (92%) 与物理治疗 (47%) 和等待 (32%) 相比显著更高.
- 然而,皮质类固醇注射组的复发率很高.
- 在52周,物理治疗 (91%) 和等待 (83%) 的成功率高于注射 (69%),物理治疗显示出明显更好的长期结果.
结论:
- 患者需要全面的信息,说明侧面表皮膜炎的每种治疗方法的优缺点.
- 物理治疗和等待政策之间的选择可能取决于资源的可用性,因为物理治疗的额外好处是边际的.
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