NEJM:物理疗法与注射糖皮质激素治疗膝关节骨性关节炎疗效比较

2020-04-09 MedSci原创 MedSci原创

与接受关节内糖皮质激素注射的患者相比,接受物理治疗的膝关节骨性关节炎患者在1年后更少出现疼痛和功能障碍。

物理治疗和关节内注射糖皮质激素已被证明对膝关节骨性关节炎具有临床疗效。但目前尚不清楚这两种治疗方法在缓解疼痛、改善机体功能方面的短期和长期疗效是否存在差异。

近日,顶级医学期刊NEJM上发表了一篇研究文章,研究人员进行了一项随机试验,旨在比较物理治疗与糖皮质激素注射在美国军事卫生系统的初级保健中的作用。单侧或双侧膝骨关节炎的患者按1:1的比例被随机分配接受糖皮质激素注射或接受物理治疗。该研究的主要结局是1年时西安大略和麦克马斯特大学骨关节炎指数(WOMAC)的总分(分数范围从0到240,分数越高表示疼痛、功能和僵硬程度越差)。

该研究共纳入156例患者,平均年龄56岁,每组78例。两组基线特征,包括疼痛的严重程度和残疾程度,是相似的。糖皮质激素注射组和物理治疗组的基线WOMAC评分平均(±SD)分别为108.8±47.1和107.1±42.4。1年后平均分分别为55.8±53.8分和37.0±30.7分(组间差异为18.8分;95%置信区间(5.0~32.6)),这一发现支持进行物理治疗。一名患者在注射糖皮质激素时晕倒。

由此可见,与接受关节内糖皮质激素注射的患者相比,接受物理治疗的膝关节骨性关节炎患者在1年后更少出现疼痛和功能障碍。

原始出处:

Gail D. Deyle.et al.Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.NEJM.2020.https://www.nejm.org/doi/full/10.1056/NEJMoa1905877

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    2020-04-11 lmm397
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  5. 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  6. 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  7. 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content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 09 15:53:36 CST 2020, time=2020-04-09, status=1, ipAttribution=)]
  8. 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content=<a href='/topic/show?id=d6dc6e814f6' target=_blank style='color:#2F92EE;'>#物理疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67814, encryptionId=d6dc6e814f6, topicName=物理疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=819120126007, createdName=lvliquan, createdTime=Sat Apr 11 03:53:36 CST 2020, time=2020-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032471, encodeId=f2aa10324e1ef, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu Apr 09 15:53:36 CST 2020, time=2020-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035217, encodeId=4799103521e17, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 09 15:53:36 CST 2020, time=2020-04-09, status=1, ipAttribution=)]
    2020-04-09 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  9. 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content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 09 15:53:36 CST 2020, time=2020-04-09, status=1, ipAttribution=)]
    2020-04-09 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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