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Prolotherapy in Musculoskeletal Disorders, Guideline for Orthopedic Application
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作者 Asma Mafhoumi Mohammad Hossein Nabian Saeed Reza Mehrpour 《Open Journal of Regenerative Medicine》 2023年第2期64-84,共21页
Purpose: Prolotherapy is a therapeutic method that involves injecting an irritant substance into injured areas of tendons, ligaments, and articular spaces. It has a wide application in orthopedic fields, including art... Purpose: Prolotherapy is a therapeutic method that involves injecting an irritant substance into injured areas of tendons, ligaments, and articular spaces. It has a wide application in orthopedic fields, including arthritis, tendinopathies, and back pain. Protocol of injection varies extensively based on the pathological condition. This review aims to discuss orthopedic applications of prolotherapy and its related outcomes, intending to introduce more specific injection protocols in each field. Methods: In a narrative review of literature, various musculoskeletal indications and contraindications of prolotherapy, as well as the method and location of injection, solution type, procedure intervals and frequencies, outcomes and side effects are investigated to reveal all aspects of the current knowledge about this new approach. Results: Chronic back pain, osteoarthritis, and tendinopathies are considered the most common indications for prolotherapy. Protocol of injection varies from one condition to another. The actual concentration of administered dextrose ranges from 12.5% to 25%. Results of the different studies indicate that prolotherapy could have a pleasing effect on improving patient’s pain and functional outcomes. No severe complication has been mentioned in previous investigations. Conclusion: Prolotherapy is a new therapeutic option that can be suggested as an effective method in recalcitrant musculoskeletal conditions. 展开更多
关键词 prolotherapy Hyperosmolar Dextrose Low Back Pain OSTEOARTHRITIS TENDINOPATHY
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高渗葡萄糖关节盘后附着注射治疗TMD慢性关节痛临床观察 被引量:1
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作者 张泽玮 刘平 +1 位作者 薛洋 周宏志 《实用口腔医学杂志》 CAS CSCD 北大核心 2024年第2期252-256,共5页
目的:观察高渗葡萄糖关节盘后附着注射(增生疗法)治疗颞下颌关节紊乱病(TMD)慢性关节痛的疗效。方法:2012年6月起纳入患者244例(16~75岁),按照DC/TMD标准分类。于关节盘后附着处,注射利多卡因1.5~2 mL,张闭口活动5~10 min,同法注射50%... 目的:观察高渗葡萄糖关节盘后附着注射(增生疗法)治疗颞下颌关节紊乱病(TMD)慢性关节痛的疗效。方法:2012年6月起纳入患者244例(16~75岁),按照DC/TMD标准分类。于关节盘后附着处,注射利多卡因1.5~2 mL,张闭口活动5~10 min,同法注射50%葡萄糖1.5~2 mL。治疗后2周、2月、6月、12月定期复诊,2023年3月终期随访。结果:终期完成随访221例(失访率9.4%),平均随访时间(75.7±25.1)月。治疗后2周患者即可有关节痛明显缓解,2月时多数患者张口/咀嚼功能明显改善,随后复查多数患者保持稳定恢复。186例经注射治疗后疼痛基本消失、张口/咀嚼功能基本正常,17例后期有张口/咀嚼功能障碍和关节痛复发表现,由于有注射恐惧改为接受咬合垫治疗,16例述注射治疗无明显效果,但也未再作其他治疗,2例后续接受手术治疗。无病例出现治疗后疼痛加重或其他并发症。结论:关节盘后附着注射高渗葡萄糖治疗TMD及慢性关节痛简单易行,安全有效。 展开更多
关键词 颞下颌关节紊乱病 慢性关节痛 关节盘后附着 高渗葡萄糖 增生疗法
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高渗葡萄糖增殖疗法治疗带状疱疹后遗神经痛的效果和安全性 被引量:1
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作者 殷琴 陈立平 +3 位作者 许恒 袁燕 梁栋 申文 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期223-227,共5页
目的·探讨高渗葡萄糖增殖疗法(hypertonic dextrose prolotherapy,DPT)治疗带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的效果和安全性。方法·选取2019年6月—2022年12月于徐州医科大学附属医院疼痛科就诊的PHN患者78例... 目的·探讨高渗葡萄糖增殖疗法(hypertonic dextrose prolotherapy,DPT)治疗带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的效果和安全性。方法·选取2019年6月—2022年12月于徐州医科大学附属医院疼痛科就诊的PHN患者78例,将患者按照1∶1随机分配至对照组和研究组,每组各39例。对照组采用传统镇痛液治疗,研究组采用传统镇痛液联合DPT治疗。采用视觉模拟评分(visual analogue scale,VAS)评估患者治疗前后的疼痛程度,使用流式细胞仪测定患者T细胞亚群情况,使用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)测定C反应蛋白(C-reactive protein,CRP)、白介素-6(interleukin-6,IL-6)及IL-10细胞因子水平。比较2组患者在治疗前,治疗后1、2、4、8及12周的VAS评分,治疗前和治疗2周后的CD4^(+)/CD8^(+)比值,CRP、IL-6、IL-10水平及不良反应发生情况。结果·2组患者的性别比例、年龄、病程差异无统计学意义。2组患者治疗后1、2、4、8及12周的疼痛评分均显著低于治疗前,差异均具有统计学意义(均P<0.05)。研究组治疗后1、2、4、8及12周的疼痛评分均显著低于对照组(均P<0.05)。2组患者治疗前CD4^(+)/CD8^(+)、CRP、IL-6及IL-10水平差异无统计学意义。治疗后研究组的IL-6、CRP水平低于对照组,差异有统计学意义(均P=0.000);治疗后研究组的CD4^(+)/CD8^(+)、IL-10水平高于对照组,差异具有统计学意义(均P=0.000)。2组患者在治疗过程中均未发生局部神经损伤、硬膜外血肿、感染、气胸、过敏等不良反应。结论·DPT可以明显缓解PHN患者疼痛,改善患者T淋巴细胞亚群和细胞因子表达,可安全应用于临床。 展开更多
关键词 高渗葡萄糖增殖疗法 带状疱疹后神经痛 T细胞计数 细胞因子
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超声引导下高渗葡萄糖注射对于距腓前韧带慢性损伤的疗效研究
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作者 廖东初 毛佶 +9 位作者 胡泽莹 王明峰 吴志彬 李鹭 朱俊杰 吴洪光 王玉琪 毛龙飞 孙熙洋 王雅珍 《空军航空医学》 2024年第4期331-334,共4页
目的研究超声引导下高渗葡萄糖注射对于距腓前韧带慢性损伤患者的治疗效果,为临床保守治疗距排前韧带慢性损伤提供相关经验。方法选取单侧踝关节扭伤慢性疼痛患者60例,将患者随机分为A组、B组,A组注射高渗葡萄糖治疗,B组行超短波联合肌... 目的研究超声引导下高渗葡萄糖注射对于距腓前韧带慢性损伤患者的治疗效果,为临床保守治疗距排前韧带慢性损伤提供相关经验。方法选取单侧踝关节扭伤慢性疼痛患者60例,将患者随机分为A组、B组,A组注射高渗葡萄糖治疗,B组行超短波联合肌内效贴布治疗,分别评估患者治疗前与治疗后1、3个月和6个月的距腓前韧带超声表现、视觉模拟评分(Visual Analogue Scale,VAS)和美国足踝外科医师协会(American Orthopedic Foot and Ankle Society,AOFAS)后足评分。结果2组治疗期间VAS评分结果显示,时间效应、组间效应和交互作用差异均有统计学意义(F组别=34.276,F时间=369.061,F交互=23.759,P均<0.001)。2组治疗期间AOFAS评分结果显示,时间效应、组间效应和交互作用差异均有统计学意义(F组别=97.236,F时间=322.951,F交互=11.175,P均<0.001)。A组治疗后1、3个月和6个月的VAS评分均较前改善,差异具有统计学意义(P均<0.001);A组治疗后1、3个月和6个月的AOFAS评分均较前改善,差异具有统计学意义(P均<0.001);B组治疗后1、3个月和6个月的VAS评分均较前改善,差异具有统计学意义(P均<0.001);B组治疗后1、3个月和6个月的AOFAS评分均较前改善,差异具有统计学意义(P均<0.001);治疗后1个月、3个月、6个月,A组VAS分数均比B组低,且差异有统计学意义(P=0.010、<0.001、<0.001);治疗后1、3个月和6个月,A组AOFAS分数均比B组高,且差异有统计学意义(P均<0.001)。结论对于距腓前韧带慢性损伤患者,超声引导下行高渗葡萄糖注射治疗安全、有效,值得临床进一步推广。 展开更多
关键词 高渗葡萄糖 距腓前韧带 增生疗法 超短波 肌内效贴
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Prolotherapy Injections for Diastasis Recti: A Case Report 被引量:5
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作者 Megan N. Strauchman Mark W. Morningstar 《Case Reports in Clinical Medicine》 2016年第9期342-346,共6页
This case report detailed the history and treatment of a female postpartum patient with diastasis recti. Treatment for this patient included the use of prolotherapy, an injection-based therapy using dextrose as the ac... This case report detailed the history and treatment of a female postpartum patient with diastasis recti. Treatment for this patient included the use of prolotherapy, an injection-based therapy using dextrose as the active compound. The solution used during the course of therapy was composed of 6 mL of 50% dextrose, 3 mL of 1% lidocaine, and 1 mL of methylcobalamin (1000 mcg/mL). Injections were administered every 2 weeks for a total of 7 prolotherapy sessions. Following the series of prolotherapy injections, there was a marked closure observed in the diastasis, decreasing from 2.7 cm to 0.5 cm. The patient did not report any side effects, and no complications were observed or recorded. This appears to be the first case report documenting an improvement in abdominal diastasis recti following a course of prolotherapy. Within the limitations of the study design, further research is recommended to evaluate prolotherapy for diastasis recti in postpartum patients. 展开更多
关键词 INJECTIONS Rectus Abdominus prolotherapy HERNIA
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增生疗法联合经颅直流电刺激治疗膝骨性关节炎疼痛的临床疗效观察 被引量:3
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作者 李娟 薛俊强 +2 位作者 腾兆伟 赵银娇 李铁山 《中国康复》 2023年第1期9-13,共5页
目的:观察增生疗法联合经颅直流电刺激治疗膝骨性关节炎疼痛的效果并探讨其作用机制。方法:选取膝骨性关节炎患者42例作为研究对象,随机分成观察组和对照组各21例。2组各有1例脱落,最终各20例完成研究。2组均给予增生治疗,即20%高渗葡萄... 目的:观察增生疗法联合经颅直流电刺激治疗膝骨性关节炎疼痛的效果并探讨其作用机制。方法:选取膝骨性关节炎患者42例作为研究对象,随机分成观察组和对照组各21例。2组各有1例脱落,最终各20例完成研究。2组均给予增生治疗,即20%高渗葡萄糖8ml关节内注射,每周1次,共3次。观察组再给以电流强度为2mA的经颅直流电刺激治疗,每天1次,每次20min,持续2周;对照组也给予电刺激治疗。但每次仅在治疗开始和结束时各提供15s的2mA电流刺激以模拟真刺激的体感知觉,其余时间无电流刺激,每天1次,每次20min,持续2周。分别于治疗前、第1次增生治疗后2、4、6周,采用视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、压痛阈(PPT)和条件性疼痛调制(CPM)对患者的膝关节功能活动及疼痛情况进行评估。结果:治疗前,2组患者的VAS、WOMAC、PPT及CPM比较均无统计学差异。在第1次增生治疗后的2、4、6周,观察组患者的VAS评分较同时间点对照组降低,CPM较同时间点对照组升高(均P<0.05);2组患者的VAS、WOMAC均较治疗前降低(均P<0.05),PPT均较治疗前升高(均P<0.05),观察组患者的CPM较治疗前升高(P<0.05)。结论:增生疗法联合tDCS的镇痛疗效优于单纯的增生疗法,既可以解决由于组织结构病变而引发的疼痛,又可以解决由于神经异常可塑导致的疼痛。 展开更多
关键词 膝骨性关节炎 增生疗法 高渗葡萄糖 经颅直流电刺激 神经异常可塑 超声引导
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高渗葡萄糖局部注射治疗膝骨关节炎疗效的Meta分析 被引量:4
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作者 叶冬梅 陈琛 +2 位作者 林紫薇 徐义明 白跃宏 《吉林大学学报(医学版)》 CAS CSCD 北大核心 2015年第3期612-618,共7页
目的:利用Meta分析方法探讨高渗葡萄糖(高渗糖)膝关节局部注射(增生疗法)对膝骨关节炎(KOA)的治疗效果,为高渗糖注射治疗KOA提供理论依据。方法:利用PubMed、Scopus和the Cochrane Library等数据库检索关于高渗糖注射对KOA疗效的随机对... 目的:利用Meta分析方法探讨高渗葡萄糖(高渗糖)膝关节局部注射(增生疗法)对膝骨关节炎(KOA)的治疗效果,为高渗糖注射治疗KOA提供理论依据。方法:利用PubMed、Scopus和the Cochrane Library等数据库检索关于高渗糖注射对KOA疗效的随机对照研究文献,按照循证医学系统的评价方法,逐一评价纳入研究的质量,提取有效的数据,采用RevMan 5.1软件对高渗糖注射组与对照组研究对象膝关节的疼痛、生理功能及僵硬等指标进行相关的Meta分析。结果:本研究共纳入5篇文献,共计355例患膝(234例患者)。Meta分析,高渗糖注射对KOA引发的疼痛有短期(SMD=-1.45,95%CI:-2.42^-0.48,P=0.003)及长期(SMD=-2.20,95%CI:-3.45^-0.94,P=0.000 6)缓解的效果。高渗糖局部注射可显著提高膝关节活动能力(SMD=-2.00,95%CI:-2.84^-1.55,P<0.000 01),但对对膝关节僵硬程度无明显改善(SMD=-0.05,95%CI:-1.02~0.03,P=0.07)。结论:高渗糖注射可有效改善KOA患者疼痛及关节活动能力,但对改善膝关节僵硬效果尚不确切。 展开更多
关键词 高渗右旋葡萄糖 增生疗法 膝关节 骨性关节炎 META分析
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Advantages of Dextrose, Platelet Rich Plasma and Stem Cells over the Traditional Conventional Methods in Treatment of Sports Injuries and Joint Osteoarthritis
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作者 Dina Mohamed Ibrahim Soliman 《Journal of Sports Science》 2017年第2期113-118,共6页
Osteoarthritis (OA) reflects a slowly evolving joint disease with toss and erosion of articular cartilage, osteophytes formation and weakness or laxity of the soft tissues in the synovial joints, particularly the la... Osteoarthritis (OA) reflects a slowly evolving joint disease with toss and erosion of articular cartilage, osteophytes formation and weakness or laxity of the soft tissues in the synovial joints, particularly the large weight-bearing joints. The prevalence of the OA increases with age, and its radiological changes can be observed in over 50% of the retired people. Symptoms can vary from minimal to severe pain, stiffness, locking, decreased function and sometimes joint effusion. Inevitably, a wide range of potential therapies have been advocated, and not necessarily with strong supportive evidence. The Standard-of-care for treatment of pain is multidisciplinary; however, a recent systematic review reported no clear benefit of any one therapy. The Agency for Healthcare Research and Quality has called for the development of new therapies for pain management. In Interventional Regenerative Orthopedic Medicine (IROM), Dextrose is used as a tissue proliferant for treatment of OA. It has different ways of action aiming to do tissue regeneration. Platelet Rich plasma is also used in IROM and is very promising because of delivering "growth-factors" which stimulate the local tissue progenitor cells (mesenchymal stem cells) enhancing the regeneration of the tissues. Adult Mesenchymal stem cells is the hot topic nowadays in the non-surgical joint reconstruction. The results revealed that patients treated for sports injuries and joint OA using IROM (dextrose, PRP and stem cells) showed a greater improvement regarding their sports performance as well as joint pain and function compared to those treated with traditional methods (different modalities of physiotherapy, steroids injections etc). Moreover, athletes with sports injuries treated with steroid injections showed a deterioration in their sports performance, muscle strain, joint pain and function. 展开更多
关键词 INJURIES pain NON-SURGICAL Lyftogt PIT prolotherapy.
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高渗葡萄糖增生疗法诱导新细胞增殖修复软组织缓解疼痛:现状与问题 被引量:10
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作者 杨丹 周晶 《中国组织工程研究》 CAS 北大核心 2019年第23期3754-3759,共6页
背景:高渗葡萄糖增生疗法是一种在肌腱和韧带附着于骨组织的部位注入增殖剂来诱导新细胞的增殖来修复软组织的疼痛管理方法,因其价格低廉、安全性高,临床应用逐渐增多。目的:就高渗葡萄糖增生疗法的概念、目前机制研究、临床研究、注意... 背景:高渗葡萄糖增生疗法是一种在肌腱和韧带附着于骨组织的部位注入增殖剂来诱导新细胞的增殖来修复软组织的疼痛管理方法,因其价格低廉、安全性高,临床应用逐渐增多。目的:就高渗葡萄糖增生疗法的概念、目前机制研究、临床研究、注意事项、禁忌证及不良反应等方面进行综述。方法:结合英文检索词(hypertonic glucose、Dextrose Prolotherapy、proliferation therapy)和中文检索词(高渗葡萄糖、增生疗法),检索PubMed、Embase、The Cochrane Library、CNKI(中国知网)、cqVIP(维普资讯网)、万方全文数据库,搜索关于高渗葡萄糖增生疗法的特点、产生及发展相关领域的文章,并进行总结和综述。结果与结论:相关细胞研究及动物实验研究了高渗葡萄糖在促进软骨修复、促纤维化以及神经血管效应方面的作用。临床研究也表明高渗葡萄糖增生疗法可以治疗多种类型的软组织损伤与疼痛类疾病,但目前实验研究机制较单一,临床试验异质性较大,随访时间较短,因此仍需开展大量的科学严谨的实验机制研究来阐明其具体机制,以及开展高质量、高同质性、长期随访的随机对照试验来验证高渗葡萄糖增生疗法的临床疗效。 展开更多
关键词 高渗葡萄糖 增生疗法 增殖疗法 软组织修复 疼痛 软骨修复 研究进展
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应用足延长器治疗足缺损9例观察报告 被引量:1
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作者 郑韶博 刘伟 +1 位作者 赵立强 李景先 《中国矫形外科杂志》 CAS CSCD 2004年第21期1660-1663,共4页
目的探讨前中足缺损的病例,应用自行设计的足延长装置在施加牵伸应力的条件下,使缺损的前中足复合组织再生的可行性。方法对9例(10足)患者采取在残留后足的跟骨、距骨截骨,以15或20mm的克氏针分别多平面穿过截骨后的跟、距骨两侧骨块,... 目的探讨前中足缺损的病例,应用自行设计的足延长装置在施加牵伸应力的条件下,使缺损的前中足复合组织再生的可行性。方法对9例(10足)患者采取在残留后足的跟骨、距骨截骨,以15或20mm的克氏针分别多平面穿过截骨后的跟、距骨两侧骨块,并与延长装置连接固定。术后调节装置每天以075~10mm的速率延长撑开器,直至达到预定延长长度。观察对比残足延长前后外形及功能的变化。结果9例病人残足平均延长825cm。再生新足皮肤(包括足底)的感觉、厚韧度及弹性正常;外形接近健侧足长度及宽度;马蹄内翻足畸形及跛行步态矫正满意。结论应用足延长器行前中足缺损延长再造新足,是解决前中足缺损所致足部继发畸形、发育障碍及功能缺陷等问题的有效途径。 展开更多
关键词 前中足 足缺损 足延长术 延长器
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Management of Musculoskeletal Pain
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作者 Dina Soliman 《Journal of Physical Science and Application》 2017年第2期27-30,共4页
Musculoskeletal pain is a distressing, unpleasant feeling and an emotional experience associated with actual or potential tissue damage. Prolotherapy is an injection therapy designed to stimulate tissue healing. Lyfto... Musculoskeletal pain is a distressing, unpleasant feeling and an emotional experience associated with actual or potential tissue damage. Prolotherapy is an injection therapy designed to stimulate tissue healing. Lyftogt PIT (perineural injection therapy) treats the neurogenic inflammation. Therefore it stops the pain and promotes the release of NGFs (nerve growth factors) which are important for tissue regeneration. Vitamin D3 receptors are ubiquitous in tissue distribution, which opens the possibility for unforeseen biological functions of vitamin D endocrine system. Dextrose is the most commonly used tissue proliferant in prolotherapy. It has different ways of action aiming to stimulate the tissue regeneration. Platelet Rich Plasma is also used in the IROM (interventional regenerative orthopedic medicine), and it is very powerful because it delivers "growth-factors" which stimulate the local tissue progenitor cells (adult mesenchymal stem cells) enhancing the regeneration of the tissues. Adult Mesenchymal stem cell is the hot topic nowadays in the non-surgical field of pain management. In this paper, 250 patients suffering from chronic pain and dysfunction of different body joints (knee, hip and elbow), were treated with one or two injection therapy techniques, to evaluate the patient improvement regarding the pain and function. The effect of adding an intra-articular injection of vitamin D to the above techniques was also evaluated regarding the joint pain and function improvement. Some of the patients were treated with Platelet Rich Plasma and others were treated with Bone Marrow Stem cells. The results of the 250 patients were compared with those obtained from 30 matching control patients, having same conditions and were treated with physiotherapy, Conclusions show that the therapeutic benefit from combining the two techniques, Lyflogt Perineural Injection Therapy and Prolotherapy, is better than using only one of them regarding the pain and function for the different body joints. Adding an intra-articular injection of vitamin D to the treatment of some patients gave a better result than those treated with dextrose only. However, using the Platelet Rich Plasma and the Stem cells instead of dextrose gave the best results ever regarding the pain and function of the musculoskeletal system. 展开更多
关键词 Dextrose prolotherapy Lyftogt PIT (perineural injection therapy) vitamin D Platelet Rich Plasma stem cells.
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增生疗法 被引量:2
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作者 Dr. Jean-Paul Ouellette Dr. Jeffrey J. Patterson +2 位作者 Dr. George Yu 许涛(译) 杜冬萍(校) 《实用疼痛学杂志》 2006年第1期3-9,共7页
骨关节炎引发的慢性疼痛目前缺乏针对性的有效治疗。增生疗法以增强韧带、肌腱以及关节囊与骨的附着为目的,通过在患病部位直接注射少量增生液,增强肌腱与韧带的弹性而达到稳定关节、减少疼痛的效果。在骨性关节炎的治疗中可取得显著的... 骨关节炎引发的慢性疼痛目前缺乏针对性的有效治疗。增生疗法以增强韧带、肌腱以及关节囊与骨的附着为目的,通过在患病部位直接注射少量增生液,增强肌腱与韧带的弹性而达到稳定关节、减少疼痛的效果。在骨性关节炎的治疗中可取得显著的疗效。文章从组织学、临床对照研究及营养性因素方面证实了增生疗法的特异疗效,从而对骨性关节炎的发病机制进行了探讨。 展开更多
关键词 增生疗法 骨关节炎 疼痛 治疗 韧带
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