高频葡萄糖浸润治疗肩袖肌腱病疼痛的疗效：系统评价和荟萃分析。

Efficacy of hypertonic dextrose infiltrations for pain control in rotator cuff tendinopathy: systematic review and meta-analysis.

机构信息

División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, México. Universidad Juárez Autónoma de Tabasco.

Centro Médico Olympia, Cancún, México.

出版信息

Acta Reumatol Port. 2021 Apr-Jun;46(2):156-170.

PMID:34243180

Abstract

INTRODUCTION

The aim of our study was to assess the efficacy of hypertonic dextrose infiltrations for pain control in individuals with rotator cuff tendinopathy and to assess the characteristics of the treatment and the presence of side effects or adverse reactions through a systematic review and meta-analysis.

METHODS

The search for the articles was performed in the electronic databases PUBMED, EMBASE, SCOPUS, SCIELO, DIALNET and Google Scholar, published up to August 2020. The keywords used were "prolotherapy" or "proliferation therapy" or "hypertonic dextrose infiltrations" or "hypertonic dextrose injection" and "Rotator Cuff" or "Rotator Cuff Injury" or "Rotator Cuff Tear" or "Rotator Cuff Tendinosis" or "supraspinatus". The effectiveness of hypertonic dextrose infiltrations was expressed as standardized mean difference (d) and 95% CI.

RESULTS

In the pooled analysis, hypertonic dextrose infiltrations were an effective intervention to reduce long-term pain in patients with rotator cuff tendinopathy when compared to controls; furthermore, in the individual analyses, hypertonic dextrose infiltrations were more effective in the short, medium and long terms than non-invasive treatments, and more effective in the long-term than infiltrations with local anesthetics. On the other hand, hypertonic dextrose infiltrations were not more effective than injections with corticosteroids or PRP. Finally, no complications or serious adverse effect were observed when hypertonic dextrose infiltrations were used.

CONCLUSIONS

We found that hypertonic dextrose infiltrations reduced pain in individuals with rotator cuff in the long-term. Hypertonic dextrose infiltrations could be an alternative to non-invasive treatments when no favorable results can be achieve. However, due to the small number of studies included in this meta-analysis, new studies are necessary to clarify the efficacy and safety of this intervention.

摘要

简介

本研究旨在评估高渗葡萄糖浸润治疗肩袖肌腱病疼痛的疗效，并通过系统评价和荟萃分析评估治疗特点、不良反应或副作用的发生情况。

方法

检索 PUBMED、EMBASE、SCOPUS、SCIELO、DIALNET 和 Google Scholar 等电子数据库，检索时间截至 2020 年 8 月，关键词为“促渗疗法”或“增殖疗法”或“高渗葡萄糖浸润”或“高渗葡萄糖注射”和“肩袖”或“肩袖损伤”或“肩袖撕裂”或“肩袖肌腱病”或“冈上肌”。高渗葡萄糖浸润的疗效用标准化均数差（d）和 95%置信区间表示。

结果

在汇总分析中，与对照组相比，高渗葡萄糖浸润治疗肩袖肌腱病患者长期疼痛有效；此外，在个体分析中，高渗葡萄糖浸润治疗在短期、中期和长期均比非侵入性治疗更有效，在长期与局部麻醉浸润相比也更有效。另一方面，高渗葡萄糖浸润治疗不如皮质类固醇或 PRP 注射有效。最后，使用高渗葡萄糖浸润治疗未观察到并发症或严重不良反应。