富血小板血浆治疗肱骨外上髁炎随机对照试验的系统评价及Meta分析  

Systematic review and Meta-analysis of randomized controlled trials of platelet-rich plasma in the treatment of lateral epicondylosis

作　　者：黄思聪 刘学东[1] 李春玲[1] 陈玉芳 李逸群[1] HUANG Si-cong;LIU Xue-dong;LI Chun-ling;CHEN Yu-fang;LI Yi-qun(Department of Orthopedics,the Second People's Hospital of Foshan City in Guangdong Province,Foshan 528000,China)

机构地区：[1]广东省佛山市第二人民医院骨科

出　　处：《中国当代医药》2020年第1期8-12,共5页China Modern Medicine

基　　金：广东省中医药局科研项目（20181127）;广东省第三批名中医师承项目;广东省佛山市科技创新项目(2017AB002831)

摘　　要：目的系统评价富血小板血浆(PRP)治疗肱骨外上髁炎(LE)的有效性和安全性。方法计算机检索Cochrane Library、WanFang Data、CNKI、VIP、PubMed和EMBASE,时限从建库至2019年3月31日,查找国内外关于PRP治疗LE的随机对照试验(RCTs),按照纳入排除标准筛选文献,并进行文献质量评价,利用RevMan 5.3软件进行Meta分析。结果最终纳入7项RCTs,共461例患者,Meta分析结果显示,1、2个月内,类固醇组在缓解疼痛、改善上肢功能方面的效果优于PRP组,差异有统计学意义(P<0.05);3个月内,两组在疼痛缓解程度和功能改善方面比较,差异无统计学意义(P>0.05);在6个月及1年后,PRP组在疼痛缓解和上肢功能改善方面的效果优于类固醇组,差异有统计学意义(P<0.05)。结论类固醇在短期内的疼痛缓解和功能改善优于PRP,然而,在远期的疼痛缓解和功能改善方面,PRP具有显著优势,且安全性良好。由于此次纳入研究较少和文献自身的局限性,今后需要进一步开展高质量的临床研究证实。Objective To systematically evaluate the efficacy and safety of platelet-rich plasma(PRP)in the treatment of lateral epicondylosis(LE).Methods Computers were searched for Cochrane Library,WanFang Data,CNKI,VIP,PubMed and EMBASE.The time limit was from the establishment of the library to March 31,2019.Randomized controlled trials(RCTs)on PRP for the treatment of LE was found.The exclusion criteria were used to screen the literature,and the literature quality was evaluated.The Meta-analysis was performed using RevMan 5.3 software.Results A total of 461 patients were included in the 7 RCTs.The results of the Meta-analysis showed that in the 1 and 2 months,the steroid group was better than the PRP group in relieving pain and improving upper limb function,and the difference was statistically significant(P<0.05).There were no significant differences in pain relief and functional improvement between the two groups within 3 months(P>0.05).After 6 months and 1 year,the effect of PRP group on pain relief and upper extremity function improvement was better than that of steroid group,the difference was statistically significant(P<0.05).Conclusion The short-term pain relief and functional improvement of steroids is superior to PRP.However,PRP has significant advantages and safety in the long-term pain relief and functional improvement.Due to the limited inclusion of research and the limitations of the literature itself,more high-quality clinical studies need to be further validated in the future.

关 键 词：肱骨外上髁炎 富血小板血浆 疼痛 系统评价 META分析 

分 类 号：R732.2[医药卫生—肿瘤]