Bae Geonhyeong, Kim Suyeon, Lee Sangseok, Lee Woo Yong, Lim Yunhee
Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Anesth Pain Med (Seoul). 2021 Jan;16(1):81-95. doi: 10.17085/apm.20078. Epub 2020 Dec 16.
Prolotherapy, which stimulates the healing of loosened ligaments and tendons, is a cost-effective and safe treatment modality for chronic musculoskeletal pain. Its benefits may be affected by injection protocols, comparative regimens, and evaluation scales. The aim of this study was to determine the effectiveness of dextrose prolotherapy as a long-term treatment for chronic musculoskeletal pain.
Medline, Embase, Cochrane Central, KoreaMed, and KMbase databases were searched for studies published up to March 2019. We included randomized controlled trials which compared the effect of dextrose prolotherapy with that of other therapies such as exercise, saline, platelet-rich plasma, and steroid injection. The primary outcome was pain score change during daily life.
Ten studies involving 750 participants were included in the final analysis. Pain scores from 6 months to 1 year after dextrose prolotherapy were significantly reduced compared to saline injection (standardized mean difference [SMD] -0.44; 95% confidence interval [CI] -0.76 to -0.11, P = 0.008) and exercise (SMD -0.42; 95% CI -0.77 to -0.07, P = 0.02). Prolotherapy yielded results similar to platelet-rich plasma or steroid injection, that it showed no significant difference in pain score.
Dextrose prolotherapy is more effective in the treatment of chronic pain compared to saline injection or exercise. Its effect was comparable to that of platelet-rich plasma or steroid injection. Adequately powered, homogeneous, and longer-term trials are needed to better elucidate the efficacy of prolotherapy.
注射疗法可刺激松弛的韧带和肌腱愈合，是一种治疗慢性肌肉骨骼疼痛的经济有效且安全的治疗方式。其疗效可能受注射方案、对照方案和评估量表的影响。本研究旨在确定葡萄糖注射疗法作为慢性肌肉骨骼疼痛长期治疗方法的有效性。
检索了Medline、Embase、Cochrane Central、KoreaMed和KMbase数据库中截至2019年3月发表的研究。我们纳入了比较葡萄糖注射疗法与其他疗法（如运动、生理盐水、富血小板血浆和类固醇注射）效果的随机对照试验。主要结局是日常生活中的疼痛评分变化。
最终分析纳入了10项研究，共750名参与者。与注射生理盐水（标准化均数差[SMD] -0.44；95%置信区间[CI] -0.76至-0.11，P = 0.008）和运动（SMD -0.42；95%CI -0.77至-0.07，P = 0.02）相比，葡萄糖注射疗法在6个月至1年后的疼痛评分显著降低。注射疗法产生的结果与富血小板血浆或类固醇注射相似，疼痛评分无显著差异。
与注射生理盐水或运动相比，葡萄糖注射疗法在治疗慢性疼痛方面更有效。其效果与富血小板血浆或类固醇注射相当。需要进行足够样本量、同质且长期的试验，以更好地阐明注射疗法的疗效。
