Jacob Neehara K, Sankaran Ravi
Physical Medicine and Rehabilitation, Amrita School of Medicine, Kochi, IND.
Physical Medicine and Rehabilitation, Aster Medcity, Kochi, IND.
Cureus. 2024 Oct 14;16(10):e71427. doi: 10.7759/cureus.71427. eCollection 2024 Oct.
The objective was to analyze the difference between prolotherapy and wet needling (WN) for myofascial trigger points (MTrPs) for the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Clinical Global Impression (CGI), and MTrP count.
Patients with myofascial pain for 1.5 years were included based on convenience sampling after a pilot study for sample size calculation. The WN group received an injection of bupivacaine 0.5% into the trigger points with WN. Participants in the dextrose prolotherapy (DPT) group received dextrose (25%) plus bupivacaine (0.5%) (1:1) into the same. Outcome measures were recorded at baseline immediate post-injection, one month, three months, and 24 months.
Among the 200 participants, there was no significant difference in the baseline VAS score between the two groups nor for immediate post-VAS. At three months of follow-up, the mean VAS was 6.34 ± 1.44 in the WN group and 1.99 ± 0.89 in the DPT group (p = 0.03). The mean VAS score significantly changed in both groups but favored the DPT group (p = 0.001) and again at 24 months (p = 0.001). The ODI showed a similar trend favoring the DPT group at all intervals. On correlating the VAS score with the ODI score, a statistically significant correlation was seen at one month, favoring the WN group, and at the end of the third month, favoring the DPT group.
Both modalities are effective at one month. At three and 24 months, the DPT was significantly more effective in improving the VAS and ODI.
分析注射疗法与水针疗法（WN）治疗肌筋膜触发点（MTrP）在视觉模拟评分法（VAS）、奥斯威斯利功能障碍指数（ODI）、临床整体印象量表（CGI）及MTrP数量方面的差异。
在进行样本量计算的预试验后，采用便利抽样法纳入患有肌筋膜疼痛1.5年的患者。WN组采用水针疗法将0.5%布比卡因注射到触发点。葡萄糖注射疗法（DPT）组将葡萄糖（25%）加布比卡因（0.5%）（1:1）注射到相同触发点。在基线、注射后即刻、1个月、3个月和24个月记录结果指标。
在200名参与者中，两组之间的基线VAS评分以及注射后即刻的VAS评分均无显著差异。在随访3个月时，WN组的平均VAS评分为6.34±1.44，DPT组为1.99±0.89（p = 0.03）。两组的平均VAS评分均有显著变化，但更有利于DPT组（p = 0.001），在24个月时也是如此（p = 0.001）。ODI在所有时间间隔均显示出有利于DPT组的类似趋势。将VAS评分与ODI评分进行相关性分析，在1个月时发现具有统计学意义的相关性，有利于WN组，在第三个月末有利于DPT组。
两种方法在1个月时均有效。在3个月和24个月时，DPT在改善VAS和ODI方面明显更有效。
