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Prolotherapy injections for chronic low back pain: a systematic review.

机译：Prolotherapy注射液治疗慢性腰痛的系统评价。

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STUDY DESIGN: A systematic review of randomized and quasi-randomized controlled trials. OBJECTIVES: To determine the efficacy of prolotherapy injections in adults with chronic low back pain. SUMMARY OF BACKGROUND DATA: Prolotherapy is an injection-based treatment for chronic low back pain. Proponents of prolotherapy suggest that some back pain stems from weakened or damaged ligaments. Repeatedly injecting them with irritant solutions is thought to strengthen the ligaments and reduce pain and disability. Prolotherapy protocols usually include co-interventions to enhance the effectiveness of the injections. METHODS: The authors searched MEDLINE, EMBASE, CINAHL, and Science Citation Index up to January 2004, and the Cochrane Controlled Trials Register 2004, issue 1, and consulted content experts. Both randomized and quasi-randomized controlled trials comparing prolotherapy injections to control injections, either alone or in combination with other treatments, were included. Studies had to include measuresof pain and disability before and after the intervention. Two reviewers independently selected the trials and assessed them for methodologic quality. Treatment and control group protocols varied from study to study, making meta-analysis impossible. RESULTS: Four studies, all of high quality and with a total of 344 participants, were included. All trials measured pain and disability levels at 6 months, three measured the proportion of participants reporting a greater than 50% reduction in pain or disability scores from baseline to 6 months. Two studies showed significant differences between the treatment and control groups for those reporting more than 50% reduction in pain or disability. Their results could not be pooled. In one, co-interventions confounded interpretation of results; in the other, there was no significant difference in mean pain and disability scores between the groups. In the third study, there was little or no difference between groups in the number of individuals who reported more than 50%improvement in pain and disability. The fourth study reporting only mean pain and disability scores showed no differences between groups. CONCLUSIONS: There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain. Conclusions are confounded by clinical heterogeneity among studies and by the presence of co-interventions. There was no evidence that prolotherapy injections alone were more effective than control injections alone. However, in the presence of co-interventions, prolotherapy injections were more effective than control injections, more so when both injections and co-interventions were controlled concurrently.
机译：研究设计：对随机和半随机对照试验的系统评价。目的：确定在慢性下腰痛的成年人中进行药物治疗的疗效。背景数据概述：Prolotherapy是一种基于注射的治疗慢性下腰痛的方法。支持者建议，一些腰痛是由韧带变弱或损坏引起的。反复向其注射刺激性溶液可增强韧带并减轻疼痛和残疾。 Prolotherapy方案通常包括共同干预以增强注射的有效性。方法：作者搜索了截至2004年1月的MEDLINE，EMBASE，CINAHL和《科学引文索引》，以及《 Cochrane对照试验注册簿》 2004年第1期，并咨询了内容专家。随机对照试验和半随机对照试验均比较了单独治疗或与其他治疗相结合的前驱疗法注射剂与对照注射剂的比较。研究必须包括干预前后的疼痛和残疾措施。两名评价者独立选择了试验并评估了方法学质量。治疗和对照组的方案因研究而异，因此无法进行荟萃分析。结果：包括四项高质量的研究，共有344名参与者。所有试验均测量了6个月时的疼痛和残疾水平，其中三项测量了参与者的疼痛或残疾评分从基线水平降低到6个月的比例降低了50％以上。两项研究表明，治疗组和对照组之间的疼痛或残疾减少幅度超过50％时，存在显着差异。他们的结果无法汇总。一方面，共同干预混淆了对结果的解释。在另一组中，两组之间的平均疼痛和残疾评分没有显着差异。在第三项研究中，报告疼痛和残疾改善超过50％的个体数量之间几乎没有差异。第四项研究仅报告了疼痛和残疾评分，表明两组之间没有差异。结论：关于在慢性下腰痛患者中减轻疼痛和残疾的方法，注射疗法的疗效存在矛盾的证据。结论因研究之间的临床异质性和联合干预的存在而混淆。没有证据表明，单独使用prolotherapy注射比单独使用对照注射更有效。但是，在存在联合干预的情况下，prolotherapy注射比对照注射更有效，当同时控制注射和联合干预时，效果更好。

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