Department of Physical Medicine and Rehabilitation, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
PLoS One. 2024 May 16;19(5):e0303537. doi: 10.1371/journal.pone.0303537. eCollection 2024.
Various injectants are available for the treatment of carpal tunnel syndrome. This systematic review and network meta-analysis was conducted to investigate the effectiveness of different injection therapies in alleviating the symptoms of carpal tunnel syndrome. Various databases were searched for relevant studies from inception until May 10, 2023. Eligible studies were identified using the patient (P), intervention (I), comparison (C), and outcomes (O) model, which involved (P) participants with carpal tunnel syndrome, (I) an intervention based on injection therapy, (C) the use of placebo or another injectant as a control treatment, and (O) the measurement of clinical and electrodiagnostic outcomes of interest. A total of 18 studies were included in the analysis. The network meta-analysis revealed that platelet-rich plasma is effective in the treatment of carpal tunnel syndrome in terms of symptom and pain relief and functional improvement in both the short and long term, whereas steroids are effective only in the short term. Additionally, injections of dextrose solution may offer long-term pain relief as well as short- and long-term symptom alleviation and functional improvement. The study findings suggest that platelet-rich plasma should be used as the first-line treatment for carpal tunnel syndrome, with dextrose and steroids serving as alternative treatment options.
各种注射剂可用于治疗腕管综合征。本系统评价和网络荟萃分析旨在调查不同注射疗法在缓解腕管综合征症状方面的有效性。从研究开始到 2023 年 5 月 10 日，我们在各种数据库中搜索了相关研究。使用患者（P）、干预（I）、比较（C）和结局（O）模型来确定符合条件的研究，其中 P 涉及腕管综合征患者，I 涉及基于注射疗法的干预，C 涉及使用安慰剂或另一种注射剂作为对照治疗，O 涉及测量临床和电诊断结局。共有 18 项研究纳入分析。网络荟萃分析显示，富血小板血浆在短期和长期内均能有效缓解腕管综合征的症状和疼痛，并改善功能；而皮质类固醇仅在短期有效。此外，葡萄糖溶液注射可能提供长期的疼痛缓解以及短期和长期的症状缓解和功能改善。研究结果表明，富血小板血浆应作为腕管综合征的一线治疗方法，而葡萄糖和皮质类固醇则作为替代治疗选择。
