前不久看到一篇循证类的文章，题目为肌腱末端病的治疗方案
Treatment of Tendinopathy。What Works,What Does Not,and What is on the Horizon
这篇文章来自：Clin Orthop Relat Res. 2008 Jul;466(7):1539-54. Epub 2008 Apr 30.
大家先看看这篇文章的摘要吧，觉得这篇文章还不错。
Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse.
肌腱末端病是指肌腱及肌腱周围由过度使用引起的疼痛，它是一个很广泛的术语。
Recent basic science research suggests little or no inflammation is present in these conditions. Thus,traditional treatment modalities aimed at controlling
inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications(NSAIDS)may not be the most effective options.
目前基础研究显示肌腱末端损伤很少甚至没有炎症。那么，传统治疗方案主要是控制炎症，例如注射皮质类固醇和使用非甾体抗炎药，这些可能都不是最有效的治疗方案。
We performed a systematic review of the literature to determine the best treatment
options for tendinopathy.
我们完成了一个系统的综述论文，目的是确定肌腱末端病的最佳治疗方案。
We evaluated the effectiveness of NSAIDS,corticosteroid injections,exercise-based physical therapy,physical therapy modalities,shock wave therapy, sclerotherapy,nitric oxide patches,surgery,growth factors, and stem cell treatment.NSAIDS and corticosteroids appear to provide pain relief in the short term,but their effectiveness in the long term has not been demonstrated.
我们评价了注射皮质类固醇、使用非甾体抗炎药、物理治疗的训练方案、理疗、冲击波疗法、硬化疗法、氧化亚氮疗法、手术、生长因子、干细胞治疗。非甾体抗炎药和皮质类固醇短期止痛效果有效，但是长期的疗效不能保证。
We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound,iontophoresis and low-level laser therapy.
我们发现冲击波治疗和理疗（例如超声波，低剂量的激光治疗）对治疗肌腱末端病存在争议。
Current data support the use of eccentric strengthening protocols,sclerotherapy,and nitric oxide patches,but larger,multicenter trials are needed to confirm the early results with these treatments.
目前数据已证实了离心肌力训练、硬化疗法、氧化亚氮疗法是肌腱末端病的有效治疗方案，但仍需更多、多中心的研究来证实这些结果。Preliminary work with growth factors and stem cells is promising,but further study is required in these fields.Surgery remains the last option due to the morbidity
and inconsistent outcomes.The ideal treatment for tendinopathy remains unclear.
