富血小板血浆与甲基强的松龙治疗肱骨外上髁炎比较

Local injection of autologous platelet-rich plasma versus methylprednisolone for lateral epicondylitis

[目的]比较自体富血小板血浆(platelet-rich plasma,PRP)与糖皮质激素甲基强的松龙(methylprednisolone,MPS)局部注射治疗肱骨外上髁炎的疗效。[方法]2016年1月~2019年3月,本院骨科就诊的64例肱骨外上髁炎患者纳入本研究,随机分为两组,每组各32例。分别给予PRP和MPS痛点局部注射治疗。比较两组患者的疼痛视觉评分(visual an⁃alogue scale,VAS)、Mayo肘关节功能评分(Mayo elbow performance score,MEPS)和肩臂手残障(disabilities of the arm,shoul⁃der and hand,DASH)评分。[结果]治疗过程中两组患者均未发生严重不良反应。随时间推移,两组患者VAS和DASH评分显著减少(P<0.05),而MEPS评分显著增加(P<0.05)。治疗前两组患者VAS评分、MEPS评分和DASH评分的差异均无统计学意义(P>0.05)。治疗后1、3个月时PRP组VAS评分和DASH评分高于MPS组,MEPS评分低于MPS组,差异有统计学意义(P<0.05)。治疗后6、12个月时,PRP组VAS评分和DASH评分低于MPS组,而MEPS评分高于MPS组,差异有统计学意义(P<0.05)。[结论]局部注射自体PRP和糖皮质激素治疗肱骨外上髁炎早期均能缓解疼痛,改善肘关节功能,而糖皮质激素治疗后期逐渐失效,PRP治疗效果逐渐提升。

[Objective]To compare the clinical outcomes of local injection of autologous platelet-rich plasma(PRP)versus glucocorti⁃coid,methylprednisolone(MPS),for treatment of lateral epicondylitis.[Methods]From January 2016 to March 2019,a total of 64 patients who were undergoing therapy in our department for lateral epicondylitis were enrolled in this study and were divided into 2 groups by ran⁃dom table method with 32 patients in each group.The local injection of PRP or MPS was conducted in the patients of the corresponding group respectively.The visual analogue scale(VAS)for pain,Mayo elbow performance score(MEPS)and disabilities of the arm,shoulder and hand(DASH)score were compared between the two groups.[Results]No severe adverse reaction happened in anyone of both groups during and after therapies.The VAS and DASH scores significantly decreased,whereas the MEPS score significantly increased over time in both groups(P<0.05).Although there was no significant difference in VAS,MEPS and DASH scores between the two groups before treat⁃ment(P>0.05),the PRP group was marked significantly higher VAS and DASH scores,whereas significantly lower MEPS score than the MPS group at 1 and 3 months after treatment(P<0.05).However,the PRP group got significantly lower VAS and DASH scores,whereas sig⁃nificantly higher MEPS score than the MPS group at 6 and 12 months after treatment(P<0.05).[Conclusion]Both PRP and MPS local in⁃jection do relieve pain and improve elbow function in early stage of treatment,by contrast,the MPS becomes impotent,while the PRP turns to be more effective in the later stage for the lateral epicondylitis.