自体富含血小板血浆与全血痛点注射治疗网球肘的病例对照研究

目的 ：比较自体富含血小板血浆与全血注射治疗网球肘的临床疗效。方法 ：2011年1月至2014年1月,门诊诊治慢性网球肘患者40例,分成两组,每组20例。一组给予自体富含血小板血浆痛点注射（PRP组）,男5例,女15例;平均年龄（47.50±9.86）岁;平均病程（4.67±3.27）个月。另一组给予自体全血痛点注射（AWB组）,男3例,女17例;平均年龄（46.50±9.96）岁;平均病程（4.53±2.27）个月。注射后给予肘关节弹力绷带制动,指导患者行伸展及力量锻炼。术后即刻及术后4、8周采用疼痛视觉模拟评分（visual analog scale,VAS）、Mayo肘关节评分及压痛阈值（pressure pain threshold,PPT）进行疗效评价。结果 ：全部患者获得随访,未发现相关并发症。VAS、Mayo评分及PPT值,PRP组分别由治疗前7.22±1.32、56.71±10.90和17.47±4.62改善至治疗后8周的2.73±1.00、91.59±6.95和21.35±4.80;AWB组分别由治疗前7.16±1.89、54.72±8.36和17.06±4.83改善至治疗后8周的3.81±1.36、82.06±7.89和20.12±4.97。两组治疗后4周评分均优于治疗前。治疗后4周,两组间PPT比较,差异无统计学意义;VAS、Mayo评分比较,AWB组低于PRP组。治疗后8周,AWB组VAS高于PRP组,Mayo评分及PPT均低于PRP组。结论：自体富含血小板血浆痛点注射治疗网球肘较自体全血痛点注射方法在疼痛缓解和功能改善方面疗效更好且持久。

Case-control study on local injection of autoallergic platelet rich plasma or whole blood for the treatment of tennis elbow

Objective: To compare therapeutic effects of local injection with autoallergic platelet rich plasma (PRP) or autoallergic whole blood (AWB) for the treatment of chronic tennis elbow.Methods: From January 2011 to January 2014,40 patients with chronic tennis elbow were divided into 2 groups,20 cases in each group:PRP group and AWB group. There were 20 patients in PRP group treated with local injection of autoallergic platelet rich plasma,including 5 males and 15 females,with an average age of (47.50±9.86) years old;and the average course of disease was (4.67±3.27) months. Among the 20 patients in AWB group treated with local injection of autoallergic whole blood,3 patients were male and 17 patients were female,with an average age of(46.50±9.96) years old;and the average course of disease was (4.53±2.27) months. The elbow joint was fixed with elastic stockings after injection. All the patients were guided to do strengthening and extension exercises during the follow-up period. Visual analog scale(VAS),Mayo scores for elbow and pressure pain threshold (PPT) were used to evaluate clinical effects after injection immediately and 4,8 weeks after treatment.Results: All the patients were followed up,there were no infections and swelling occurred. The VAS,Mayo and PPT scores of patients in PRP group were improved from pre-therapy 7.22±1.32,56.71±10.90 and 17.47±4.62 to 2.73±1.00,91.59±6.95 and 21.35±4.80 respectively 8 weeks after treatment. The VAS,Mayo and PPT scores of patients in AWB group were improved from pre-therapy 7.16±1.27,54.72±8.36 and 17.06±4.83 to 3.81±1.36,82.06±7.89 and 20.12±4.97 respectively 8 weeks after treatment. All the pain and functional variables including VAS,PPT,and Mayo scores were improved significantly in both groups 4 weeks after injection. On the 4th week after injection,there was no statistically significant difference in PPT between two groups;while the VAS and Mayo score of AWB group were lower than those of PRP group. On the 8th week after injection,the VAS of AWB group was higher than that of PRP group;but the Mayo and PPT scores of AWB group were lower than those of PRP group.Conclusion: PRP and AWB injections are both effective to treat chronic lateral epicondylitis. Compared with AWB injection,PRP injection may be more effective in releasing pain and improving function for a longer time.