Azizi Fatemeh, Saber Gharesoo Faezeh, Eidy Fereshteh, Heidari Sama, Maghbouli Nastaran, Djalalinia Shirin, Kasaeian Amir
Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Heliyon. 2025 Jan 3;11(1):e41622. doi: 10.1016/j.heliyon.2025.e41622. eCollection 2025 Jan 15.
Entrapment neuropathies, marked by nerve compression at various anatomical sites, can be effectively managed using conservative approaches like injections. Dextrose 5 % water injection has emerged as a potential therapy by reducing inflammation and promoting tissue regeneration. We aimed to evaluate dextrose injection's efficacy in treating entrapment neuropathies in upper extremities.
We systematically searched EMBASE, Scopus, Web of Science, and PubMed. Our eligibility criteria included participants aged 18 and older who had peripheral upper limb nerve entrapment from non-metabolic and non-traumatic sources. These participants were treated with dextrose injection compared to those receiving other injectables, such as corticosteroids and non-corticosteroid medications. The primary outcome was pain, with secondary outcomes including function, ultrasonographic, and electrodiagnostic findings. The quality of the clinical trials was assessed using Cochrane tools. Random-effect model was employed for meta-analysis.
Thirteen studies, involving 754 patients, were included, with only two showing serious bias risk. Initial findings indicate significant pain relief with dextrose injection within a short time (≤4 weeks) compared to normal saline (MD: -1.30, 95%CI: -2.12; -0.47). Dextrose also demonstrated a significant pain decrease compared to corticosteroids (MD: -0.81, 95 % CI: -1.40; -0.21) with low heterogeneity (I = 9 %, P = 0.36), and significantly improved function (MD = -0.46, 95 % CI: -0.76; -0.16) with low heterogeneity (I = 17 %, P = 0.31) in mid-term (one to six months).
This meta-analysis suggests dextrose injection as an effective therapy for managing pain and restoring function in entrapment neuropathies. However, further high-quality studies are needed to confirm these findings and establish optimal dosing regimens and injection protocols. Healthcare providers should consider integrating dextrose injection into their treatment strategies for patients with entrapment neuropathies.
以不同解剖部位神经受压为特征的卡压性神经病，可通过注射等保守方法有效治疗。5%葡萄糖水注射已成为一种潜在的治疗方法，可减轻炎症并促进组织再生。我们旨在评估葡萄糖注射治疗上肢卡压性神经病的疗效。
我们系统检索了EMBASE、Scopus、科学网和PubMed。我们的纳入标准包括年龄在18岁及以上、因非代谢性和非创伤性原因导致上肢周围神经卡压的参与者。与接受其他注射剂（如皮质类固醇和非皮质类固醇药物）的参与者相比，这些参与者接受葡萄糖注射治疗。主要结局是疼痛，次要结局包括功能、超声和电诊断结果。使用Cochrane工具评估临床试验的质量。采用随机效应模型进行荟萃分析。
纳入了13项研究，涉及754例患者，只有两项显示出严重的偏倚风险。初步结果表明，与生理盐水相比，葡萄糖注射在短时间内（≤4周）能显著减轻疼痛（MD：-1.30，95%CI：-2.12；-0.47）。与皮质类固醇相比，葡萄糖也显示出疼痛显著减轻（MD：-0.81，95%CI：-1.40；-0.21），异质性较低（I²=9%，P=0.36），并且在中期（1至6个月）功能显著改善（MD=-0.46，95%CI：-0.76；-0.16），异质性较低（I²=17%，P=0.31）。
这项荟萃分析表明，葡萄糖注射是治疗卡压性神经病疼痛和恢复功能的有效疗法。然而，需要进一步的高质量研究来证实这些发现，并确定最佳给药方案和注射方案。医疗保健提供者应考虑将葡萄糖注射纳入其对卡压性神经病患者的治疗策略中。
