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高渗葡萄糖注射治疗肩袖疾病和滑囊炎的疗效:一项随机对照试验。

Effects of Hyperosmolar Dextrose Injection in Patients With Rotator Cuff Disease and Bursitis: A Randomized Controlled Trial.

机构信息

Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Mackay Medical College, Taipei.

Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei.

出版信息

Arch Phys Med Rehabil. 2021 Feb;102(2):245-250. doi: 10.1016/j.apmr.2020.08.010. Epub 2020 Sep 11.

Abstract

OBJECTIVE

To determine whether dextrose prolotherapy offers clinical benefits in patients with shoulder pain and bursitis.

DESIGN

Double-blinded, randomized controlled trial.

SETTING

Outpatient rehabilitation department of a single medical center.

PARTICIPANTS

Patients (N=50) who had received a diagnosis of shoulder pain and bursitis through clinical tests and ultrasound examination.

INTERVENTIONS

Participants were randomly assigned to the 15% dextrose injection (D15W) group or the placebo group to receive either D15W or normal saline injection, respectively. All participants received ultrasound-guidance bursal injection every 2 weeks for a total of 3 injections.

MAIN OUTCOME MEASURES

The primary outcome was maximal pain level while performing activities. The secondary outcomes included resting pain level, function and disability assessment results, and ultrasonographic parameters. Participants were followed up for 3 months after completion of the injection course.

RESULTS

No significant differences in baseline characteristics were observed between the D15W and placebo groups. Significant time effects were observed for all outcome parameters (all P<.05); however, time × group effects were nonsignificant for all outcomes, except for tissue elasticity (P=.026).

CONCLUSIONS

Supporting evidence is insufficient regarding the clinical benefits of 15% dextrose bursal injection administered through 3 sessions in patients with chronic shoulder pain and bursitis. The findings indicate that these injections may increase the tissue stiffness of the supraspinatus tendon, as indicated by elastography assessment results, but further research is required to determine the nature of such changes in elastography findings.

摘要

目的

确定葡萄糖水疗法治疗肩部疼痛和滑囊炎患者是否具有临床益处。

设计

双盲、随机对照试验。

地点

单一医疗中心的门诊康复科。

参与者

通过临床检查和超声检查诊断为肩部疼痛和滑囊炎的患者(N=50)。

干预措施

参与者被随机分配到 15%葡萄糖注射液(D15W)组或安慰剂组,分别接受 D15W 或生理盐水注射。所有参与者均接受超声引导下滑囊注射,每 2 周 1 次,共 3 次。

主要观察指标

主要结局是活动时的最大疼痛程度。次要结局包括静息疼痛程度、功能和残疾评估结果以及超声参数。注射疗程结束后随访 3 个月。

结果

D15W 组和安慰剂组在基线特征方面无显著差异。所有结局参数均表现出显著的时间效应(均 P<.05);然而,除组织弹性(P=.026)外,所有结局的时间×组效应均无统计学意义。

结论

关于慢性肩部疼痛和滑囊炎患者接受 3 次 15%葡萄糖滑囊注射的临床益处,证据不足。研究结果表明,这些注射可能会增加冈上肌腱的组织硬度,如弹性成像评估结果所示,但需要进一步研究来确定弹性成像结果中这些变化的性质。

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