运动员腱止点末端病的研究进展

目的:就近年来有关腱止点末端病的研究报道,对腱止点末端病的研究现状进行阐述。资料来源:应用计算机检索Medline数据库1990-01/2006-12期间的相关文章,检索词为“Enthesopathy”和“tendinopathy”,限定文章语言种类为英文。同时计算机检索万方数据资源系统与中国期刊全文数据库1994-01/2005-12期间的相关文章,检索词“腱止点,末端病,腱病”,限定文章语言种类为中文。资料选择:选取与腱止点末端病的基础和临床相关的文献,排除重复性实验研究。资料提炼:共收集到20篇关于细胞因子在肌腱损伤愈合方面的基础和临床相关实验文章,16篇实验文章纳入标准。排除的4篇实验均为重复的同一研究。资料综合:①腱止点末端结构主要由4部分组成,其结构特点比较复杂;主要功能是传导和缓冲应力。②腱止点末端病的病因、病理目前还不清楚;一般认为其病因主要是末端结构失代偿,病理主要是胶原和软骨的退行性变。③通过各种理疗手段,能够改善腱止点末端的临床症状;但不能从根本上消除病因。结论:目前对腱止点末端结构的研究比较透彻,对末端病的病因、病理及与细胞凋亡的关系还了解较少,同时对于末端病的治疗目前还缺少可靠的科学方法,因此有必要对目前的治疗方法进行严密设计,随机研究其效果,同时还应积极开展对其他治疗方法(基因疗法、细胞因子疗法)的探索和研究。

Tendinopathy enthesiopathy in athletes

BACKGROUND: Enthesiopathy, one of the three tough problems in sports medicine is a frequent disease in athletes;treatments to enthesiopathy determine the performance record and sports span of athletes in a big extent.DATA SOURCES: The relevant articles from 1990 to 2006 were searched for in NCBI Entrez PubMed by input the key words "enthesiopathy" and "tendinopathy" in English into a computer. Similarly, the relevant articles in Chinese from 1994 to 2006 were searched for in CNKI and Wangfang Data.STUDY SELECTION: Articles about preclinical and clinical research of enthesiopathy in athlete, the excluded articles were those about repetitive studies.DATA EXTRACTION: A total of 20 relevant literatures were collected, including 16 included articles and 4 excluded articles due to repetitive study.DATA SYNTHESIS: ① The main structure of ten-insertion which is very multiplicity contains 4 different tissues, the main function of it is to transmit and absorb shocks. ② So far it is not very clear about the etiopathogenisis and pathological change of enthesiopathy; It is considered that enthesiopathy actually is the result of decompensation in the ten-insertion and degeneration of collagen fiber and cartilaginous is the main pathological change; ③ Nonoperative therapy can abate the clinical symptom, but the curative effect is not affirmative.CONCLUSION: So far it is very clear about the anatomic structure of ten-insertion, but it is not very clear about the etiopathogenisis and pathological change of enthesiopathy and the relationship between enthesiopathy and apoptosis.Scientific and reliable therapies are scarce, strict design and random research of the existing therapies to enthesiopathy are very necessary; for importance, research and exploratory in other therapies including gene therapy and cell factor therapy is a very hopeful direction of the treatment in enthesiopathy.