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首页> 外文期刊>Rheumatology >Conservative treatments for tennis elbow do subgroups of patients respond differently?
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Conservative treatments for tennis elbow do subgroups of patients respond differently?

机译：网球肘的保守疗法患者亚组有不同反应吗？

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OBJECTIVES: To determine if subgroups of patients with tennis elbow respond differently in treatment. METHODS: This study used individual patient data (n = 383) from two randomized controlled trials that investigated a wait-and-see policy, corticosteroid injections and physiotherapy. Common outcome measures were: pain severity, global improvement, severity assessed by a blinded assessor, elbow disability and pain free grip strength. Subgroup analyses for previous history of elbow pain, baseline pain severity, duration of the current episode and employment status were performed at 6 and 52 weeks. RESULTS: Patients' age, previous elbow symptoms and baseline pain severity were similar between trials, but other characteristics differed between trial populations. Based on individual patient data from both trials, we found that corticosteroid injections were statistically and clinically superior at 6 weeks, but significantly worse at 52 weeks compared with both wait-and-see and physiotherapy. Subgroup effects were scarce and small. Patients with higher baseline pain score showed less benefit on pain outcomes between physiotherapy and a wait-and-see policy at 6 weeks. It also appeared that non-manual workers who had an injection were the only work subgroup to follow the general trend that injections were significantly worse than a wait-and-see policy on global improvement at 52 weeks. CONCLUSION: The treatment outcomes were largely similar between trials and not different between most subgroups studied. In tennis elbow, it would appear that patient characteristics play only a small role in predicting treatment outcomes, which supports the generalizability of individual trial results.
机译：目的：确定网球肘患者亚组在治疗中是否有不同反应。方法：本研究使用来自两项随机对照试验的个体患者数据（n = 383），该试验研究了一种观望政策，糖皮质激素注射和理疗。常见的预后指标为：疼痛严重度，总体改善，由盲人评估者评估的严重度，肘关节残疾和无痛握力。在第6和52周进行亚组分析，以了解肘部疼痛的既往史，基线疼痛的严重程度，当前发作的持续时间和就业状况。结果：试验之间的患者年龄，先前的肘部症状和基线疼痛严重程度相似，但试验人群之间的其他特征有所不同。根据两项试验的个体患者数据，我们发现皮质类固醇注射在6周时具有统计学和临床​​上的优势，但在52周时显着低于观望和物理疗法。亚组的影响很小且很小。在6周时，基线疼痛评分较高的患者在物理治疗和“静观其变”政策之间对疼痛结局的获益较小。看来，接受注射的非体力劳动者是遵循总体趋势的唯一工作小组，该趋势是在52周时注射明显比全球改善的观望政策差。结论：各试验之间的治疗结果基本相似，而大多数研究亚组之间无差异。在网球肘中，患者的特征似乎在预测治疗结果中仅发挥很小的作用，这支持了各个试验结果的普遍性。

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