富血小板血浆与皮质醇激素治疗腱病的荟萃分析△

Platelet-rich plasma versus corticosteroid for tendinopathy: a meta analysis

摘要:

[目的] 通过荟萃分析评价富含血小板血浆（platelet-rich plasma, PRP） 注射与皮质类固醇（corticosteroid, CS） 注射治疗肌腱病的疗效和安全性。[方法] 检索Pubmed, Cochrane Library, Embase 和Web of Science 中PRP 注射与CS 注射肌腱病的随机对照试验（randomized controlled trials, RCT） 文献。使用Jadad 量表评估文献质量，采用Revman 5.3 软件进行荟萃分析。[结果] 共纳入15 项研究，纳入957 例患者。荟萃分析结果显示：治疗后1 个月CS 组VAS 评分显著优于PRP 组[MD=0.85, 95%CI 0.12~1.58, P=0.02]。治疗后3 个月两组VAS 评分差异无统计学意义（P＞0.05），治疗后6 个月，PRP 组VAS 评分显著优于CS组[MD=-1.95, 95%CI 3.14~0.77, P＜0.001]。治疗后1、3 个月，两组AOFAS 评分的差异均无统计学意义（P＞0.05），治疗6 个月后，PRP 组AOFAS 评分显著优于CS 组[MD=5.25, 95%CI 2.45~8.06, P=0.0002]。治疗后1、3 个月，两组DASH 评分的差异均无统计学意义（P＞0.05）。[结论] 对于肌腱病的患者，短期的治疗效果CS 优于PRP，中期疗效两者无明显差异，长期治疗效果PRP 优于CS。

Abstract:

[Objective] To evaluate the efficacy and safety of platelet -rich plasma (PRP) versus corticosteroid (CS) therapy for tendinop-athy by using meta-analysis. [Methods] Randomized controlled trials (RCT) on PRP versus CS in Pubmed, Cochrane Library, Embase andWeb of Science were searched. Use Jadad to evaluate the quality of the literature, the data extracted from the literature was subjected to me-ta-analysis by using Revman 5.3 software. [Results] A total of 15 studies were included into this analysis, involving 957 patients. As resultsof meta-analysis, the CS group proved significantly superior to the PRP group in term of VAS score one month after treatment [MD=0.85,95%CI 0.12~1.58, P=0.02], while which became not significantly different between the two groups 3 months after treatment (P＞0.05). How-ever, the PRP group was significantly better than CS group 6 months after treatment in term of VAS score [MD=-1.95, 95%CI 3.14~0.77, P＜0.001]. At 1 and 3 months after treatment, there was no statistical significance in AOFAS score between the two groups (P＞0.05). At 6months after treatment, AOFAS score in PRP group was significantly better than that in CS group [MD=5.25, 95%CI 2.45~8.06, P=0.0002].At 1 and 3 months after treatment, there was no significant difference in DASH scores between the two groups (P＞0.05). [Conclusion] Forpatients with tendinopathy, CS is better than PRP in short-term therapeutic effect, which become not significantly different in the mediumtermtherapeutic effect, and while the PRP is better than CS in term of long-term therapeutic effect.