小剂量曲安奈德治疗跟痛症的疗效观察

Small Doses of Triamcinolone Aacetonide for Heel Pain

目的观察小剂量曲安奈德行局部封闭治疗跟痛症的临床疗效。方法 400例跟痛症患者随机分为两组,注射小剂量曲安奈德的为治疗组(n=200),行2%利多卡因4mL加曲安奈德5mg混合后局部痛点注射;注射常规剂量曲安奈德的为对照组(n=200),行2%利多卡因4mL加曲安奈德40mg混合后局部痛点注射。400例患者均为每周治疗1次,3次为1个疗程,治疗3周后比较两组的疗效,并对患者随访1年以观察复发情况。结果治疗3周后,治疗组治愈157例,显效23例,好转12例,无效8例,有效率为96%,治愈率79%;对照组治愈164例,显效16例,好转14例,无效6例,有效率为97%,治愈率82%。两组有效率及治愈率之间的差异无统计学意义(P>0.05)。对治疗有效的患者随访1年。治疗组中失访15例,随访患者中有12人复发,复发率为7%;对照组中失访18例,随访患者中有11人复发,复发率6%。两组复发率之间的差异无统计学意义(P>0.05)。结论小剂量曲安奈德局部封闭治疗跟痛症疗效确切可靠,值得在临床中广泛推广。

Objective To observe the curative effect of small doses of triamcinolone acetonide in the treatment of heel pain. Methods Total 400 cases of heel pain were divided randomly into two groups：treatment group and control group with 200 in each. The treatment group was treated by using line 2% lidocaine dmL plus triamcinolone acetonide 5mg for infection into the local trigger point and the control group was treated by using injection of conventional doses of triamcinolone acetonide and line 2% lidocaine 4mL plus triamcinolone acetonide 40mg for infection into the local trigger point. Both groups were treated once a week,with three times as a course of treatment,and after three-week treatment,the curative effect of the two groups was compared and all cases were followed up one year to observe the recurrence. Results After three-week treatment,157 cases were cured,23 effective,12 improved and 8 cases showed no efficiency,with the effective rate of 96% and the cure rate of 79% in the treatment group. In the control group,164 cases were cured,16 effective,14 improved and 6 showed no efficiency,with the effective rate of 97% and the cure rate of 82%. There was no significant difference in the effective rate and recovery rate between the two groups （P〉0.05）. One year follow-up showed no significant difference in the recurrence rate between the two groups （P〉0.05）. Conclusion The partial closure of a small dose of triamcinolone acetonide in the treatment of heel pain is reliable, worthy of being clinically popularized.