单剂量皮损内富血小板血浆注射与单剂量皮质类固醇注射治疗足底筋膜炎的功能效果比较研究

Dr. Mouneshwaran R, Dr. Vijayaragavan R
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摘要

背景介绍足底筋膜炎是足跟疼痛的常见原因。在某些情况下,它会导致严重的发病率,如果保守治疗无效,就需要进行富血小板血浆(PRP)注射和/或局部类固醇注射等侵入性治疗。与局部注射类固醇相比,血小板丰富血浆是否能更有效地减轻疼痛和改善功能,目前仍存在争议。目的和目标:根据视觉模拟疼痛量表(VAS)对足底筋膜炎患者在两周后、三个月后和六个月后的功能结果,确定单剂量皮内注射 PRP 和单剂量皮内注射类固醇的疗效,并比较两者的疗效。研究方法对骨骼发育成熟、接受过保守治疗但无效的足底筋膜炎患者进行比较研究,将其随机分为两组:PRP 组和类固醇组。使用视觉模拟量表(VAS)评估患者发病当天的疼痛情况,以及治疗后 2 周、3 个月和 6 个月的疼痛情况。研究结果共有 60 名患者参与研究,并随机分为两组--类固醇组和 PRP 组各 30 人。结果显示,在 2 周、3 个月和 6 个月时,PRP 组的 VAS 明显低于类固醇组。与类固醇注射相比,PRP 组在 6 个月时的 VAS 评分有很大改善。随着注射时间的延长,结果和差异更加明显,6 个月的随访观察到了最大效益。没有一名患者在 6 个月后需要再次注射。结论与皮质类固醇相比,注射 PRP 能更好地缓解足底筋膜炎患者的疼痛并改善其功能。与之前的研究相比,结果几乎相似,即注射 PRP 比注射类固醇治疗足底筋膜炎效果更好。
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A comparative study of functional outcome of single dose intra-lesional platelet rich plasma injection versus single dose corticosteroid injection for plantar fasciitis
Background: Plantar fasciitis is a common cause of heel pain. In some cases, it can lead to significant morbidity and then invasive procedures like Platelet Rich Plasma (PRP) injection and/or intralesional steroid injection are required, in whom conservative treatment is unresponsive. It is still controversial whether PRP is more effective in reducing pain and also improving the function compared to intralesional steroid. Aims & Objectives: To determine efficacy of single dose Intralesional-PRP injection and single dose Intralesional-Corticosteroid injection, also to compare the efficacy between the both in Plantar fasciitis based on the functional outcome by Visual Analogue Pain scale (VAS) at end of 2weeks, 3rd months and 6th months. Methodology: A comparative study on skeletally mature patients with plantar fasciitis who had underwent conservative therapy but failed, were randomized into 2 groups: PRP and Steroid group. Using Visual Analog Scale (VAS), participants were assessed for pain on the Day of presentation, and then after therapy at 2 weeks, 3 months and 6 months. Results: Total of 60 patients were included in the study and randomized into 2 groups -30 for steroid group and 30 for PRP group. Results showed that VAS of PRP group was significantly lower than that of steroid group at 2weeks, 3months and 6 months. PRP was associated with great improvement in VAS score at 6months compared to steroid injection. The result and difference were more pronounced as the time from injection increased and maximal benefit was observed at 6 months follow-up. None of the patients needed a repeat injection at 6 months. Conclusion: PRP injections provide better pain relief and function, compared to corticosteroids, in patients with plantar fasciitis. On comparison with previous studies, results were almost similar that is superiority of PRP over steroid injection in plantar fasciitis.
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