| 富血小板血浆与皮质类固醇治疗肩袖肌腱病疗效对比的Meta分析 |
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Received:September 19, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 孙润杰 |
SUN Run-jie |
山西医科大学第二医院骨科 山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 郭丽 |
GUO Li |
山西医科大学第二医院骨科 山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 李鹏翠 |
LI Peng-cui |
山西医科大学第二医院骨科 山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 卫小春 |
and WEI Xiao-chun |
山西医科大学第二医院骨科 山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
sdeygksys@163.com |
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| 期刊信息：《中国骨伤》2022年35卷，第12期，第1170-1176页 |
| DOI：10.12200/j.issn.1003-0034.2022.12.012 |
| 基金项目:国家自然科学基金区域联合重点资助项目（编号：U21A20353）；国家自然科学基金面上项目（编号：82172503）；山西省基础研究计划自然科学研究面上项目（编号：20210302123263，20210302123285）；山西省基础研究计划青年科学研究项目（编号：20210302124670） |
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目的：探讨富含血小板血浆（platelet-rich plasma，PRP）注射与皮质类固醇（corticosteroids，CS）注射治疗肩袖肌腱病在肩关节功能恢复、疼痛缓解和关节活动度方面的临床疗效。
方法：计算机检索Cochrane Library，EMBASE，PebMed，中国知网（CNKI），万方数据库中PRP注射与CS注射肩袖肌腱病的随机对照试验（randomized controlled trial，RCT）文献，检索时间为建库至2022年4月20日。由2名研究者根据纳入和排除标准，进行文献筛选、数据提取及质量评价，并采用Review Manager 5.4.1软件对提取的数据进行统计学分析。比较注射后短期（3~6周）、中期（8~12周）、长期（≥ 24周）的视觉模拟评分（visual analogue scale，VAS），美国肩肘医师协会（American Shoulder and Elbow Surgeons，ASES）评分，西安大略肩袖疾病评分指数（Western Ontario Rotator Cuff Index，WORC），以及肩关节活动度（range of motion，ROM）。
结果：共纳入7篇RCT文献，共379例患者，其中PRP组188例，CS组191例。Meta分析结果显示：两组在短期和中期随访内VAS、ASES及WORC比较，差异无统计学意义（P>0.05）。长期随访ASES评分[MD=7.1，95% CI （2.06，12.14），P=0.006]和VAS[MD=-1.55，95% CI （-2.65，-0.55），P=0.002]比较，差异有统计学意义。两组ROM比较，差异无统计学意义（P>0.05）。
结论：对于肩袖肌腱病的患者，PRP与CS在疼痛缓解及功能恢复方面的短期和中期随访疗效相似。然而，长期随访发现，PRP较CS在功能恢复和疼痛缓解方面体现出优势。肩关节活动度在整个随访期间无明显差异。 |
| [关键词]:富血小板血浆 皮质类固醇 肌腱病 Meta分析 |
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| Platelet-rich plasma vs corticosteroid for treatment of rotator cuff tendinopathy: a Meta-analysis |
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Abstract:
Objective: To explore clinical effects regrarding functional recovery, pain relief, and range of motion of shoulder of platelet-rich plasma (PRP) injection and corticosteroid(CS) injection in treating rotator cuff tendinopathy.
Methods: Randomized controlled trials (RCT) of PRP injection and CS injection in Cochrane Library, EMBASE(Excerpta Medica Database), PebMed, China knowledge Network(CNKI) and Wanfang database were searched from building database to April 20, 2022. According to inclusion and exclusion criteria, literature screening, data extraction and quality evaluation were carried out between two independent researchers, and extracted data were statistically analyzed by Review Manager 5.4.1 software. Short-term (3-6 weeks), medium-term (8-12 weeks) and long-term (≥ 24 weeks) visual analogue score (VAS), American Shoulder and Elbow Surgeons (ASES) score, Xi'an Western Ontario Rotator Cuff Index (WORC) and shoulder range of motion (ROM) were compared between two groups.
Results: Totally 7 RCT were included with 379 patients, 188 patients in PRP group and 191 patients in CS group. Meta analysis results showed there were no significant difference in VAS, ASES and WORC between short-term group and medium-term group(P>0.05). During long-term follow-up, there were significant differences in ASES score[MD=7.1, 95%CI(2.06, 12.14), P=0.006] and VAS[MD=-1.55, 95%CI(-2.65, 0.55), P=0.002]. There was no significant difference in shoulder ROM between two groups(P>0.05).
Conclusion: For patients with shoulder cuff tendon disease, there are no significant difference in pain relief and functional recovery during short and medium-term follow-up period. However, RPR injection showed advantages over corticosteroid injection in terms of functional recovery and pain relief during long-term follow-up. There is no significant difference in shoulder range of motion between two groups during the whole follow-up period. |
| KEYWORDS:Platelet-rich plasma Corticosteroids Tendinopathy Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙润杰,郭丽,李鹏翠,卫小春.富血小板血浆与皮质类固醇治疗肩袖肌腱病疗效对比的Meta分析[J].中国骨伤,2022,35(12):1170~1176 |
| 英文格式: | SUN Run-jie,GUO Li,LI Peng-cui,and WEI Xiao-chun.Platelet-rich plasma vs corticosteroid for treatment of rotator cuff tendinopathy: a Meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1170~1176 |
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