Department of Neuro-Orthopedics, University Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil.
Department of Medicine I, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Medicine (Baltimore). 2023 Sep 22;102(38):e35163. doi: 10.1097/MD.0000000000035163.
Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is not known, but osmotic agents (hypertonic solutions of dextrose or glucose) cause cellular rupture and an inflammatory response that releases cytokines and growth factors that lead to scarring and reinnervation.
Patients with chronic LBP (>12 weeks) who were non-traumatic and unresponsive to at least 1 month of physical therapy were selected. All patients were followed up at a return visit at 1, 3, and 6 months for pain assessment using validated pain questionnaires and scales.
Nineteen patients were included in the conservative group and 19 in the glucose group, with the majority being women (57.9%). The patients were between 47 and 59 years of age (39.5%), mixed race (76.33%), married or in a committed relationship (73.7%), and had completed the study for 5.2 years. Overall mean body mass index was 27.3 ± 4.4 kg/m 2 and was higher in the conservative group (28.0 ± 4.7 kg/m 2 ). The groups showed differences in Visual Analog Scale scores, with median and amplitude values close to each other between the time points evaluated and increasing values in the glucose group, which had significantly higher values for this scale at the third evaluation ( P = .031). When comparing the Rolland-Morris scale scores between the groups, there was a significant difference only in the 3-m assessment ( P = .021). In the follow-up assessment, both groups showed significant improvement between T0 and the other assessment time points ( P < .05) in all evaluations.
Both groups significantly improved on the evaluated scales during follow-up. Overall, no effects were attributable to the glucose components or the prolotherapy protocol.
慢性下腰痛（LBP）定义为疼痛持续时间超过 3 个月，是社会影响最大的疾病之一。治疗方法复杂，包括在增生疗法中使用的增生剂。其机制尚不清楚，但渗透剂（高渗葡萄糖或葡萄糖溶液）会导致细胞破裂和炎症反应，释放细胞因子和生长因子，导致瘢痕形成和再神经支配。
选择非创伤性且对至少 1 个月的物理治疗无反应的慢性 LBP（>12 周）患者。所有患者在 1、3 和 6 个月时进行随访，使用经过验证的疼痛问卷和量表评估疼痛。
保守组和葡萄糖组各纳入 19 例患者，大多数为女性（57.9%）。患者年龄在 47 至 59 岁之间（39.5%），混合种族（76.33%），已婚或处于稳定关系（73.7%），并完成了 5.2 年的研究。总体平均体重指数为 27.3±4.4kg/m 2 ，保守组更高（28.0±4.7kg/m 2 ）。两组在视觉模拟评分上存在差异，各时间点的中位数和振幅值接近，葡萄糖组的评分值逐渐升高，在第三次评估时该评分显著更高（P=0.031）。比较两组的 Rolland-Morris 量表评分，只有在 3 个月的评估中存在显著差异（P=0.021）。在随访评估中，两组在所有评估中均在 T0 和其他评估时间点之间显示出显著改善（P<0.05）。
两组在随访期间在评估量表上均显著改善。总体而言，葡萄糖成分或增生疗法方案均无效果。
