高剂量与低剂量的类固醇注射用于粘合性囊炎 (冷肩):系统性审查和元分析
Seong Jun Kim1, Jong Mi Park1, Junmin Song2
1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Pain physician
|September 29, 2023
概括
这次元分析发现,高剂量和低剂量内类固醇注射之间的疼痛,运动范围或功能没有显著差异. 由于副作用较少,建议使用低剂量注射.
科学领域:
- 整形外科 整形外科 整形外科
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 关节内类固醇注射是一种常见的冷肩部治疗方法 (粘合性囊炎).
- 目前还没有确立的科学基础来确定这些注射的最佳或认证剂量.
- 剂量变化可能会影响治疗疗效和患者的治疗结果.
研究的目的:
- 为了比较高剂量和低剂量内关节内类固醇注射对冷肩的有效性.
- 为了确定减少疼痛,肩膀运动范围 (ROM) 和功能改善的潜在差异.
- 为在冷肩部治疗中提供基于证据的类固醇注射剂量建议.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 在MEDLINE,EMBASE和Cochrane数据库中搜索到2023年2月15日.
- 分析数据使用标准化平均差异 (SMD) 和GRADE方法来评估证据质量.
主要成果:
- 包括四项涉及274名患者的研究.
- 在高剂量和低剂量组之间,没有发现疼痛 (SMD 0.10),ROM (SMD 0.07) 或功能改善 (SMD 0.08) 的显著差异.
- 在3周,6周和1年后的亚组分析显示,没有显著的临床差异. 高剂量类固醇使用时,冲洗更频繁.
结论:
- 目前的证据表明,高剂量和低剂量类固醇注射之间的结果没有显著差异.
- 考虑到潜在的副作用,建议开始使用低剂量类固醇治疗.
- 需要进一步的研究来确定基于疾病严重程度的最佳剂量方案.
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