Reeves K D, Hassanein K
Meadowbrook Rehabilitation Hospital, Gardner, Kansas, USA.
J Altern Complement Med. 2000 Aug;6(4):311-20. doi: 10.1089/10755530050120673.
To determine the clinical benefit of dextrose prolotherapy (injection of growth factors or growth factor stimulators) in osteoarthritic finger joints.
Prospective randomized double-blind placebo-controlled trial.
SETTINGS/LOCATION: Outpatient physical medicine clinic.
Six months of pain history was required in each joint studied as well as one of the following: grade 2 or 3 osteophyte, grade 2 or 3 joint narrowing, or grade 1 osteophyte plus grade 1 joint narrowing. Distal interphalangeal (DIP), proximal interphalangeal (PIP), and trapeziometacarpal (thumb CMC) joints were eligible. Thirteen patients (with seventy-four symptomatic osteoarthitic joints) received active treatment, and fourteen patients (with seventy-six symptomatic osteoarthritic joints) served as controls.
One half milliliter (0.5 mL) of either 10% dextrose and 0.075% xylocaine in bacteriostatic water (active solution) or 0.075% xylocaine in bacteriostatic water (control solution) was injected on medial and lateral aspects of each affected joint. This was done at 0, 2, and 4 months with assessment at 6 months after first injection.
One-hundred millimeter (100 mm) Visual Analogue Scale (VAS) for pain at rest, pain with joint movement and pain with grip, and goniometrically-measured joint flexion.
Pain at rest and with grip improved more in the dextrose group but not significantly. Improvement in pain with movement of fingers improved significantly more in the dextrose group (42% versus 15% with a p value of .027). Flexion range of motion improved more in the dextrose group (p = .003). Side effects were minimal.
Dextrose prolotherapy was clinically effective and safe in the treatment of pain with joint movement and range limitation in osteoarthritic finger joints.
确定葡萄糖促渗疗法（注射生长因子或生长因子刺激剂）治疗手指骨关节炎的临床疗效。
前瞻性随机双盲安慰剂对照试验。
门诊物理医学诊所。
每个研究关节需有6个月疼痛病史，且符合以下情况之一：2级或3级骨赘、2级或3级关节间隙变窄、1级骨赘加1级关节间隙变窄。远端指间关节（DIP）、近端指间关节（PIP）和大多角骨掌关节（拇指CMC）符合条件。13例患者（74个有症状的骨关节炎关节）接受积极治疗，14例患者（76个有症状的骨关节炎关节）作为对照。
在每个患侧关节的内侧和外侧注射0.5毫升10%葡萄糖和0.075%利多卡因的抑菌水溶液（活性溶液）或0.075%利多卡因的抑菌水溶液（对照溶液）。分别在0、2和4个月时进行注射，并在首次注射后6个月进行评估。
采用100毫米视觉模拟量表（VAS）评估静息痛、关节活动痛和握力痛，并通过量角器测量关节屈曲度。
葡萄糖组静息痛和握力痛改善更明显，但差异无统计学意义。葡萄糖组手指活动痛改善更显著（42%对15%，p值为0.027）。葡萄糖组关节屈曲活动范围改善更明显（p = 0.003）。副作用极小。
葡萄糖促渗疗法治疗手指骨关节炎的关节活动痛和活动范围受限临床有效且安全。
