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单次注射富血小板血浆与皮质类固醇治疗膝骨关节炎的效果比较:一项双盲随机临床试验

Effect of single injection of platelet-rich plasma in comparison with corticosteroid on knee osteoarthritis: a double-blind randomized clinical trial.

作者信息

Forogh Bijan, Mianehsaz Elaheh, Shoaee Shervan, Ahadi Tannaz, Raissi Gholam R, Sajadi Simin

机构信息

Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Firouzgar Hospital, Tehran, Iran -

出版信息

J Sports Med Phys Fitness. 2016 Jul-Aug;56(7-8):901-8. Epub 2015 Jul 14.

Abstract

BACKGROUND

Evidence on the effect of platelet-rich plasma (PRP) in treating osteoarthritis (OA) is insufficient. Therefore, the present study compares the effects of a one-time injection of PRP and corticosteroid (CS).

METHODS

In the present randomized double blind clinical trial, the participants who suffered from knee osteoarthritis (Grades II/III), were randomly divided into two groups: intra articular injection of PRP and CS. Knee injury and osteoarthritis outcome score (KOOS), the 20-Meter-Walk Test (20MW), active and passive ranges of motions (ROM), flexion contracture, and pain intensity based on Visual Analog Scale (VAS) were assessed before, 2-months, and 6-months after interventions.

RESULTS

Forty-one participants (48 knees) were involved in the research (66.7% women; average age of 61.1±7.0 years old). Compared to the group treated with corticosteroid, pain relief (df: 6, 35; F=11.0; P=0.007), symptom free (df:6, 35; F=23.0; P<0.001), activities of daily living (ADL) (df:6, 35; F=10.7; P=0.005) and quality of life (df:6, 35; F=5.2; P=0.02) in the RPR group were significantly higher, but sporting ability was not different between the two groups (df: 6, 35; F=0.6; P=0.55). PRP was significantly more helpful for relieving patients' pain (VAS) compared to corticosteroids (df: 6, 35; F=32.0; P=0.001). It is also notable that using PRP was more helpful in improving the 20MW test than corticosteroid treatment (df: 6, 35; F=7.4; P=0.04) but none of the treatments had any impact on active flexion ROM، passive flexion ROM and flexion contracture (P>0.05).

CONCLUSIONS

Our study demonstrated that one shot of PRP injection, decreased joint pain more and longer-term, alleviated the symptoms, and enhanced the activity of daily living and quality of life in short-term duration in comparison with CS.

摘要

背景

关于富血小板血浆(PRP)治疗骨关节炎(OA)效果的证据不足。因此,本研究比较了一次性注射PRP和皮质类固醇(CS)的效果。

方法

在本随机双盲临床试验中,将患有膝关节骨关节炎(II/III级)的参与者随机分为两组:关节内注射PRP和CS。在干预前、干预后2个月和6个月评估膝关节损伤和骨关节炎结果评分(KOOS)、20米步行试验(20MW)、主动和被动活动范围(ROM)、屈曲挛缩以及基于视觉模拟量表(VAS)的疼痛强度。

结果

41名参与者(48个膝关节)参与了研究(女性占66.7%;平均年龄61.1±7.0岁)。与皮质类固醇治疗组相比,PRP组的疼痛缓解(自由度:6, 35;F = 11.0;P = 0.007)、无症状(自由度:6, 35;F = 23.0;P < 0.001)、日常生活活动(ADL)(自由度:6, 35;F = 10.7;P = 0.005)和生活质量(自由度:6, 35;F = 5.2;P = 0.02)显著更高,但两组的运动能力无差异(自由度:6, 35;F = 0.6;P = 0.55)。与皮质类固醇相比,PRP在缓解患者疼痛(VAS)方面明显更有效(自由度:6, 35;F = 32.0;P = 0.001)。还值得注意的是,使用PRP在改善20MW试验方面比皮质类固醇治疗更有帮助(自由度:6, 35;F = 7.4;P = 0.04),但两种治疗对主动屈曲ROM、被动屈曲ROM和屈曲挛缩均无影响(P > 0.05)。

结论

我们的研究表明,与CS相比,一次性注射PRP在短期内能更有效且更持久地减轻关节疼痛、缓解症状,并提高日常生活活动能力和生活质量。

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