Objectives To investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo ointment and eccentric exercise. Methods This was a single-site randomised double-blind placebo-controlled trial at an acute hospital, Dublin, Ireland. Patients with chronic mid-portion Achilles tendinopathy were randomised to either 24 weeks of daily GTN ointment or placebo ointment. Both groups received an identical 12-week eccentric exercise programme. The primary outcome measure was the Victorian Institute of Sport Assessment–Achilles (VISA-A) questionnaire at 24 weeks, which measures pain, function and activity. Secondary outcomes included pain severity, self-reported physical function, calf muscle function, pressure pain thresholds and ultrasound changes. Statistical analyses were performed according to intention-to-treat principles. Results 76 patients (30 women; 46 men, mean age±SD, 45.6±8.2 years) were recruited for the trial. Significant improvements in VISA-A scores occurred in both groups at 6-week, 12-week and 24-week follow-up. The increase was not significantly different between groups, adjusted mean between-group difference from baseline to week 6, –1.33 (95% CI –6.96 to 4.31); week 12, −1.25 (95% CI −8.0 to 5.49) and week 24, –3.8 (95% CI –10.6 to 3.0); negative values favour GTN. There was no significant between-group difference in any of the secondary outcome measures at 6, 12 and 24 weeks. Conclusions Adding daily GTN ointment over 24 weeks to a 12-week eccentric exercise programme did not improve pain, function and activity level in patients with chronic mid-portion Achilles tendinopathy when compared with placebo ointment. Data are available on reasonable request.

中文翻译：

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局部三硝酸甘油 (GTN) 和离心运动治疗中部跟腱病（NEAT 试验）：一项随机双盲安慰剂对照试验


目的 探讨每日使用三硝酸甘油 (GTN) 软膏治疗超过 24 周并结合 12 周离心运动计划是否比安慰剂软膏和离心运动更有效治疗慢性中段跟腱病。方法 这是在爱尔兰都柏林一家急症医院进行的单中心随机双盲安慰剂对照试验。患有慢性中段跟腱病的患者被随机分配接受 24 周的每日 GTN 软膏或安慰剂软膏治疗。两组均接受相同的为期 12 周的离心运动计划。主要结果指标是第 24 周时的维多利亚运动评估研究所 - 阿基里斯 (VISA-A) 问卷，用于测量疼痛、功能和活动。次要结果包括疼痛严重程度、自我报告的身体功能、小腿肌肉功能、压痛阈值和超声变化。根据意向治疗原则进行统计分析。结果 试验招募了 76 名患者（30 名女性；46 名男性，平均年龄±SD，45.6±8.2 岁）。随访 6 周、12 周和 24 周时，两组 VISA-A 评分均出现显着改善。各组之间的增加没有显着差异，从基线到第 6 周调整后的平均组间差异为 –1.33（95% CI –6.96 至 4.31）；第12周，-1.25（95% CI -8.0至5.49）和第24周，–3.8（95% CI –10.6至3.0）；负值有利于 GTN。 6、12 和 24 周时，任何次要结果指标均无显着组间差异。结论 与安慰剂软膏相比，在为期 12 周的离心运动计划中添加每日 GTN 软膏超过 24 周，并不能改善慢性中段跟腱病患者的疼痛、功能和活动水平。 可根据合理要求提供数据。