Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Tianjin Hospital, Tianjin, China.
Medicine (Baltimore). 2023 Mar 10;102(10):e33112. doi: 10.1097/MD.0000000000033112.
Discogenic low back pain (DLBP) has been influencing people's quality of life. Research on platelet-rich plasma (PRP) for DLBP has increased in recent years, but systematic summaries are lacking. This study analyzes all published studies related to the use of intradiscal injection of PRP for the treatment of DLBP and summarizes evidence-based medicine for the efficacy of this biologic treatment for DLBP.
Articles published from the inception of the database to April 2022 were retrieved from PubMed, the Cochrane Library, Embase, ClinicalTrial, the Chinese National Knowledge Infrastructure, Wanfang, Chongqing VIP Chinese Scientific Journals, and the Chinese Biomedicine databases. After the rigorous screening of all studies on PRP for DLBP, a meta-analysis was performed.
Six studies, including 3 randomized controlled trials and 3 prospective single-arm trials, were included. According to this meta-analysis, pain scores decreased by >30% and >50% from baseline, with incidence rates of 57.3%, 50.7%, and 65.6%, and 51.0%, 53.1%, and 51.9%, respectively, after 1, 2, and 6 months of treatment. The Oswestry Disability Index scores decreased by >30% with an incidence rate of 40.2% and by >50% with an incidence rate of 53.9% from baseline after 2 and 6 months, respectively. Pain scores decreased significantly after 1, 2, and 6 months of treatment (standardized mean difference: 1 month, -1.04, P = .02; 2 months, -1.33, P = .003; and 6 months, -1.42, P = .0008). There was no significant change (P > .05) in the pain scores and the incidence rate when pain scores decreased by >30% and >50% from baseline between 1 and 2 months, 1 and 6 months, and 2 and 6 months after treatment. No significant adverse reactions occurred in any of the 6 included studies.
Intradiscal injection of PRP is effective and safe in the treatment of DLBP, and there was no significant change in the patient's pain 1, 2, and 6 months after PRP treatment. However, confirmation is required by additional high-quality studies due to the limitations of the quantity and quality of the included studies.
椎间盘源性下腰痛（DLBP）一直影响着人们的生活质量。近年来，对富含血小板的血浆（PRP）治疗 DLBP 的研究有所增加，但缺乏系统的总结。本研究分析了所有与椎间盘内注射 PRP 治疗 DLBP 相关的已发表研究，并总结了这种生物治疗 DLBP 的疗效的循证医学证据。
从数据库建立之初到 2022 年 4 月，从 PubMed、Cochrane 图书馆、Embase、ClinicalTrials、中国国家知识基础设施、万方、重庆 VIP 中文科技期刊和中国生物医学数据库中检索到与 PRP 治疗 DLBP 相关的所有文章。对所有关于 PRP 治疗 DLBP 的研究进行严格筛选后，进行了荟萃分析。
纳入了 6 项研究，包括 3 项随机对照试验和 3 项前瞻性单臂试验。根据这项荟萃分析，疼痛评分从基线下降了>30%和>50%，发生率分别为 57.3%、50.7%和 65.6%，51.0%、53.1%和 51.9%，分别在治疗后 1、2 和 6 个月。Oswestry 残疾指数评分从基线下降>30%的发生率为 40.2%，下降>50%的发生率为 53.9%，分别在治疗后 2 和 6 个月。治疗后 1、2 和 6 个月疼痛评分均显著下降（标准化均数差：1 个月，-1.04，P=0.02；2 个月，-1.33，P=0.003；6 个月，-1.42，P=0.0008）。治疗后 1 个月和 2 个月、1 个月和 6 个月、2 个月和 6 个月时，疼痛评分下降>30%和>50%的发生率之间无显著变化（P>.05）。在纳入的 6 项研究中，均未发生明显不良反应。
椎间盘内注射 PRP 治疗 DLBP 有效且安全，PRP 治疗后 1、2 和 6 个月患者疼痛无明显变化。但是，由于纳入研究的数量和质量存在局限性，需要更多高质量的研究来证实。
