关节内注射富血小板血浆与高渗葡萄糖注射疗法治疗膝骨关节炎的比较效果——一项随机对照试验
The comparative effects of injecting intra-articular platelet-rich plasma and hypertonic dextrose prolotherapy in osteoarthritis knee - A randomized control trial.
作者信息
Singh Neeraj, Gupta Anil K, Kumar Dileep, Mishra Sudhir, Yadav Ganesh, Singh Shreya
机构信息
Department of Physical Medicine and Rehabilitation (PMR), Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of PMR, King George's Medical University, Lucknow, Uttar Pradesh, India.
出版信息
J Family Med Prim Care. 2025 Jun;14(6):2180-2186. doi: 10.4103/jfmpc.jfmpc_1206_24. Epub 2025 Jun 30.
INTRODUCTION
Knee osteoarthritis is an age-dependent disease caused by degenerative and healing processes in subchondral tissue of articular and bone cartilage, resulting in changes of its biochemical properties that eventually causes pain, stiffness, and decreased articular function. Therefore, this study aims to compare the effectiveness of platlet-rich plasma (PRP) therapy and 25% hypertonic dextrose (Dextrose) prolotherapy in patients with knee osteoarthritis.
MATERIAL AND METHODS
Single-blind randomized control trial was conducted for 18 months. Patients satisfying the inclusion and exclusion criteria were enrolled from the indoor/outdoor facility of the Department of Physical Medicine and Rehabilitation, King George's Medical University (KGMU), Lucknow, India. The informed consent form was duly signed by all the enrolled patients, who were randomly assigned into two groups by the computer-generated system, A total of 85 study participants in this group I (43 patients) received 5 ml Platelet-Rich Plasma (PRP) and Group II (42 patients) received 5 ml of 25% hypertonic dextrose prolotherapy (Dextrose). To compare the effect in terms of reduction of pain, according to the Numeric pain rating scale (NPRS) and Pain/Discomfort, Walking and Activities of Daily Living (ADL) according to the Lequesne Knee Index (LKI) and assessment of each patient was done at specified period, i.e., 0 weeks (Baseline means immediately before intervention), and 6 weeks after the intervention.
RESULT
Overall, the baseline to 6 weeks change of LKI-Pain in group I (PRP) was significantly more than the group II (DEXTROSE) ( < 0.001). On considering the parameter of LKI-Pain at baseline and 6 weeks for PRP and Dextrose, it was found that in Group I, the mean ± SD reduced more at 6 weeks from 4.81 ± 1.55 to 2.44 ± 1.76 as compared to participants in Group II with 4.83 ± 1.17 at baseline to 6 weeks 3.64 ± 0.98, LKI-Activities of Daily Living (ADL) for group I PRP the Mean ± SD score dropped more from 4.66 ± 1.40 to 2.95 ± 1.35 whereas for group II Dextrose the Mean ± SD score dropped from 4.68 ± 1.40 to 3.65 ± 1.51 at baseline and 6 week respectively and At baseline, the mean LKI-Total score in group I was 12.85 ± 3.59 while in group II the mean score was 13.11 ± 3.15. At 6 weeks, the mean LKI-Total score in group I was 7.63 ± 3.85; in group II the mean score was 10.11 ± 2.93. A significant difference was found in the mean LKI-Total score between the groups at 6 weeks ( = 0.001) and found to be lesser in group I.
CONCLUSION
It could thus be concluded that on considering the effect of platelet-rich plasma and 25% hypertonic dextrose prolotherapy in patients with knee osteoarthritis, significant improvement was seen in participants administered with both platelet-rich plasma and dextrose with the higher effect being with platelet-rich plasma.
引言
膝关节骨关节炎是一种与年龄相关的疾病,由关节软骨和骨软骨下组织的退行性和愈合过程引起,导致其生化特性发生变化,最终引起疼痛、僵硬和关节功能下降。因此,本研究旨在比较富血小板血浆(PRP)疗法和25%高渗葡萄糖(右旋糖)注射疗法对膝关节骨关节炎患者的疗效。
材料与方法
进行了为期18个月的单盲随机对照试验。从印度勒克瑙乔治国王医科大学(KGMU)物理医学与康复科的室内/室外设施中招募符合纳入和排除标准的患者。所有入选患者均签署了知情同意书,通过计算机生成系统将他们随机分为两组。本研究中,第一组(43例患者)共85名研究参与者接受5毫升富血小板血浆(PRP),第二组(42例患者)接受5毫升25%高渗葡萄糖注射疗法(右旋糖)。为了比较在减轻疼痛方面的效果,根据数字疼痛评分量表(NPRS)以及根据勒凯纳膝关节指数(LKI)评估的疼痛/不适、行走和日常生活活动(ADL),并在特定时间段,即0周(基线指干预前即刻)和干预后6周对每位患者进行评估。
结果
总体而言,第一组(PRP)从基线到6周LKI-疼痛的变化显著大于第二组(右旋糖)(<0.001)。考虑PRP和右旋糖在基线和6周时的LKI-疼痛参数,发现第一组中,与第二组参与者相比,6周时平均值±标准差从4.81±1.55降至2.44±1.76,第二组基线时为4.83±1.17,6周时为3.64±0.98。第一组PRP的LKI-日常生活活动(ADL)平均值±标准差得分从4.66±1.40降至2.95±1.35,而第二组右旋糖在基线和6周时平均值±标准差得分分别从4.68±1.40降至3.65±1.51。基线时,第一组的平均LKI总分是12.85±3.59,而第二组的平均得分是13.11±3.15。6周时,第一组的平均LKI总分是7.63±3.85;第二组的平均得分是10.11±2.93。两组在6周时的平均LKI总分存在显著差异(=0.001),且第一组较低。
结论
因此可以得出结论,考虑富血小板血浆和25%高渗葡萄糖注射疗法对膝关节骨关节炎患者的疗效,接受富血小板血浆和葡萄糖治疗的参与者均有显著改善,其中富血小板血浆的效果更佳。
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