富血小板血浆治疗足底筋膜炎的随机对照实验Meta分析

Treatment of Plantar Fasciitis with Platelet-Rich Plasma: A Meta-Analysis

目的:系统评价富血小板血浆(PRP)治疗足底筋膜炎的有效性。方法:利用互联网技术来检索CNKI、Wangfang Data、Pubmed、Ebsco、Pedro和Cochrane Library,查找一些使用PRP和类固醇等激素注射治疗足底筋膜炎的相关资料,检索时间为近五年,截至2021年4月。按照制订的纳入排除标准筛选文章并进行文献质量评价,同时进行仔细甄别经筛选的各篇文章,并合理地对其内容进行了相关文献的综合质量指标评估,且应用了Rev Man5.3软件进行Meta分析。结果:本Meta分析最终纳入6项研究,共397名患者。Meta结果分析表明,3个月内,类固醇联合组缓解足部疼痛及改善脚踝等脚趾足部肌肉运动生理功能的效果优于PRP组(P 【0.05);而在6个月后,PRP组在帮助治疗慢性疼痛和帮助增强脚踝足部肌肉活动等生理功能时的效果显著程度优于其他两种类固醇治疗组,效果的明显差别也均具有重要统计学事实意义(P 【0.05);在3个月内和6个月后,PRP组在足底筋膜厚度的改善率上明显优于其他类固醇组,效果的差别具有统计学意义(P 【0.05)。结论:类固醇激素治疗对于短期内疼痛减轻及其功能提升优于PRP,但是对于远期疼痛减轻及其功能提升,PRP具有明显的优势。由于此次纳入研究的相关文献及实验数据资料较少且存在着较大的异质性,因此我们需要从中获取到更多高质量的临床研究证据。

Objective: To evaluate the efficacy of platelet rich plasma (PRP) in the treatment of plantar fasciitis. Methods: The method is to search CNKI, Wangfang data, PubMed, EBSCO, Pedro and Cochrane Library by using Internet technology to find some relevant information about the treatment of plantar fasciitis with hormone injection such as PRP and steroids. The search time is nearly five years, up to April 2021. According to the selected criteria which are listed as exclusion factors, the article is screened, and the quality of the literature is reasonably evaluated. Revman 5.3 software was used for meta-analysis. Results: Six randomized controlled trials with 397 subjects were selected. Meta analysis showed that, within 3 months, the efficacy of steroid group in treating foot pain and improving foot movement function such as ankle was significantly better than that of PRP group (P <0.05);after 6 months, PRP group was significantly better than other steroid groups in treating chronic pain and enhancing foot movement function (P <0.05);within 3 months and 6 months, the improvement rate of plantar fascia thickness in PRP group was significantly better than that in other steroid groups, and the difference was statistically significant (P <0.05). Conclusion: Steroid therapy is superior to PRP in short-term pain relief and function improvement, but PRP has obvious advantages in long-term pain relief and function improvement. Due to the lack of relevant literature and experimental data, we need to obtain more high-quality clinical research evidence.