文献简介

出版社:JOURNAL OF FOOT AND ANKLE RESEARCH

作  者:Lisa J Farndon, Wesley Vernon, Stephen J Walters, Simon Dixon, Mike Bradburn, Michael Concannon

编  号:

关键字:Foot, Pain, Podiatry, Callosities, Debridement

年  份:2013   点击量:988

文献摘要

 

Abstract

Background: Corns are a common foot problem and surveys have indicated that between 14-48% of people suffer from them. Many of these will seek podiatry treatment, however there is little evidence to indicate which current treatments provide long term resolution. This study compared ‘usual’ treatment (enucleation with a scalpel) with the application of 40% salicylic acid plasters to corns to investigate which is the most effective in terms of clinical, economic and patient-centred outcomes.

背景:鸡眼是一种常见的足部问题,调查表明,14-48%的人患有鸡眼。许多患者想要寻求足部治疗,然而,很少有证据表明目前的治疗能够长期解决问题。本项研究比较了“常规的”的治疗法(手术刀去除术)和使用40%水杨酸膏药治疗鸡眼的疗效,依据临床、经济和以病人为中心的结果,调查两种方法中哪一种方法最有效。

Methods: A parallel-group randomised controlled trial was carried out in two centres where adults who presented with one or more corns and who met the inclusion criteria were allocated to either ‘usual’ scalpel debridement or corn plaster treatment. All participants had measurements of corn size, pain using a 100 mm visual analogue scale (VAS) and health-related quality of life (EQ-5D) measures by an independent podiatrist, blind to treatment allocation at baseline, 3, 6, 9 and 12 months.

方法:平行组随机对照试验在两个小组中进行,患有一个或多个鸡眼并且符合入选标准的成年人被随机分配到“常规的”手术刀清创术或鸡眼膏药治疗两组中的任意一组。由一个独立的足科医生随机分配治疗,在0369 12个月时采用100毫米的视觉模拟评分法(VAS)和健康相关的生活质量(EQ -5D)措施对所有参与者的鸡眼大小和疼痛程度进行测量。

Results: 202 participants were randomised to receive scalpel debridement or corn plaster treatment (101 in each group). At 3 months 34% (32/95) of corns had completely resolved in the corn plaster group compared with 21% (20/94) in the scalpel group (p = 0.044), and 83% (79/95) had reduced in size in the corn plaster group compared with 56% (53/94) in the scalpel group (p < 0.001). At 12 months, time to corn recurrence was longer in the corn plaster group (p < 0.001). Pain from the corns was significantly lower in the corn plaster group at 3 months (p < 0.001) and EQ-5D scores changed (improved), from baseline, by 0.09 (SD ±0.31) and 0.01 (SD ±0.25) points in the corn plaster and scalpel groups respectively (p = 0.056). By month 12, EQ-5D scores had changed by 0.12 and −0.05 in the corn plaster and scalpel groups respectively (p = 0.005). The EQ-5D, VAS scores and the four domains of the Foot Disability Scale were similar in both groups at 3 and 12 months. The economic analysis indicated that corn plasters were a cost effective intervention.

结果: 202名参与者被随机分配接受手术刀清创术治疗或鸡眼膏药治疗(每组101人)。3个月时,与手术刀组21%(20/94)的治愈率相比,鸡眼膏治疗组中34%(32/ 95)的患者鸡眼被彻底治愈(p = 0.044);在鸡眼膏治疗组中,83%(79/ 95)患者的鸡眼尺寸减小,而手术刀组中为 56%(53/ 94 )(P < 0.001)。12个月时,鸡眼膏组的鸡眼复发时间延长(P < 0.001)。3个月时,鸡眼膏治疗组的鸡眼疼痛程度明显降低(P < 0.001),EQ-5D分数改变,鸡眼膏组和手术刀组分别比治疗前提高了0.09分(SD±0.31)和0.01分(SD ±0.25)(P = 0.056 )。12个月时,鸡眼膏组的EQ -5D分数提高了0.12分,手术组的降低了0.05分(P = 0.005)。在两组中,EQ - 5DVAS评分和足残疾量表的四个区域在3个月和12个月时是相似的。经济学分析表明,鸡眼膏药是一个经济实惠的治疗方法。

Conclusions: The use of corn plasters was associated with a higher proportion of resolved corns, a prolonged time to corn recurrence, less pain and reduced corn size over the first 6 months in comparison with ‘usual’ scalpel treatment and this intervention was cost effective. Used under supervision of a podiatrist on appropriate patients, corn plasters offer an effective alternative to scalpel debridement.

结论:治疗6个月后,与“常规的”的手术刀治疗方法相比,使用鸡眼膏治愈鸡眼的比例较高、鸡眼复发时间延长、痛苦较少、鸡眼尺寸减小,而且更加经济实惠。在足科医生的监督下使用鸡眼膏给特定的患者提供了一个有效的可以替代手术刀清创术的治疗方法。