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首页> 外文期刊>Annals of the Rheumatic Diseases: A Journal of Clinical Rheumatology and Connective Tissue Research >Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials.
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Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials.

机译：激素注射治疗肩肘肌腱炎的疗效和安全性：一项随机对照试验的荟萃分析。

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OBJECTIVES: To assess the efficacy and safety of steroid injections for patients with tendonitis of the shoulder or elbow. METHODS: A systematic review of the literature using PubMed, EMBASE, the Cochrane library and manual searches was performed until April 2008. All randomised controlled trials (RCTs) reporting the efficacy on pain or functional disability, and/or the safety of steroid injections, versus placebo, non-steroidal anti-inflammatory drugs (NSAIDs) or physiotherapy in patients with tendonitis were selected. Pooled effect size (ES) was calculated by meta-analysis using the Mantel-Haenszel method. RESULTS: In all, 20 RCTs were analysed (744 patients treated by injections and 987 patients treated by controls; 618 shoulders and 1113 elbows). The pooled analysis indicated only short-term effectiveness of steroids versus the pooled controls for pain and function (eg, pain at week 1-3 ES = 1.18 (95% CI 0.27 to 2.09), pain at week 4-8 ES = 1.30 (95% CI 0.55 to 2.04), pain at week 12-24 ES = -0.38 (95% CI -0.85 to 0.08) and pain at week 48 ES = 0.07 (95% CI -0.60 to 0.75)). Sensitivity analyses indicated similar results whatever the localisation, type of steroid and type of comparator except for NSAIDs: steroid injections were not significantly better than NSAIDs in the short-term. Steroid injections appeared more effective than pooled other treatments in acute or subacute tendonitis. The main side effects were transient pain after injection (10.7% of corticosteroid injections) and skin modification (4.0%). CONCLUSIONS: Steroid injections are well tolerated and more effective for tendonitis in the short-term than pooled other treatments, though similar to NSAIDs. No long-term benefit was shown.
机译：目的：评估类固醇注射液对肩或肘肌腱炎患者的疗效和安全性。方法：使用PubMed，EMBASE，Cochrane库和人工搜索对文献进行系统的回顾，直到2008年4月。所有随机对照试验（RCT）报告了疼痛或功能障碍的疗效和/或类固醇注射的安全性，与安慰剂相比，在肌腱炎患者中选择了非甾体类抗炎药（NSAIDs）或物理疗法。使用Mantel-Haenszel方法通过荟萃分析计算合并效应量（ES）。结果：总共分析了20个RCT（744例接受注射治疗的患者和987例接受对照治疗的患者; 618例肩膀和1113例肘）。汇总分析表明，类固醇相对于汇总对照组仅在疼痛和功能方面具有短期有效性（例如，第1-3周ES的疼痛= 1.18（95％CI 0.27至2.09），第4-8周ES = 1.30的疼痛（ 95％CI 0.55至2.04），第12-24周ES的疼痛= -0.38（95％CI -0.85至0.08）和第48 ES周的疼痛= 0.07（95％CI -0.60至0.75））。敏感性分析表明，除了NSAIDs以外，无论其定位，类固醇类型和比较剂类型如何，结果均相似：短期内，类固醇注射剂并不明显优于NSAIDs。在急性或亚急性肌腱炎中，类固醇注射似乎比合并其他疗法更有效。主要的副作用是注射后的短暂疼痛（皮质类固醇注射剂的10.7％）和皮肤修饰（4.0％）。结论：尽管与非甾体类抗炎药相似，类固醇注射液在短期内比合并的其他疗法耐受性更好，对肌腱炎更有效。没有显示长期获益。

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