淺談增生療法

10.6666/ClinMed.201901_83(1).0004

楊凱銘；周正亮

增生療法(prolotherapy) ； 增生劑(proliferant) ； 葡萄糖增生注射治療(dextrose prolotherapy)

臨床醫學月刊

83卷1期（2019 / 01 / 25）

22 - 27

繁體中文

Prolotherapy取名來自拉丁文proli-，有「生長」的意思，中文稱做「增生療法」。然而增生療法是一種泛稱，任何促進人體自行修復的方式皆可稱之，其中較廣為人知的是「增生注射治療」，有人又直接稱增生治療，是把增生劑(proliferant)注射到肌腱、韌帶等軟組織，促進修復的一種注射技術，而增生劑是指配合增生療法能夠幫助人體自我修復的物質。目前常聽到的增生劑有葡萄糖溶液(dextrose)、高濃度血小板血漿(platelet-rich plasma, PRP)、幹細胞等。相較PRP收費高昂，葡萄糖便宜又安全的特性，使得葡萄糖注射成為目前接受度最高的增生療法。關於增生注射治療的適應症，目前證據力較強的有下列病症，肱骨外上髁炎(lateral epicondylitis of the elbow)、Osgood-Schlatter disease、顳顎關節症候群(temporomandibular joint dysfunction)、膝關節炎、手指關節炎、薦髂關節疼痛(sacroiliac joint pain)。

1. History of HHFP.< https://hhpfoundation.org>
2. Bertrand, H,Reeves, KD,Bennett, CJ(2016).Dextrose prolotherapy versus control injections in painful rotator cuff tendinopathy.Arch Phys Med Rehabil,97,17-25.
3. Centeno, CJ,Elliott, J,Elkins, WL(2005).Fluoroscopically guided cervical prolotherapy for instability with blinded pre and post radiographic reading.Pain Physician,8,67-72.
4. Dumais, R,Benoit, C,Dumais, A(2012).Effect of regenerative injection therapy on function and pain in patients with knee osteoarthritis a randomized crossover study.Pain Med,13,990-999.
5. Eslamian, F,Amouzandeh, B(2015).Therapeutic effects of prolotherapy with intra-articular dextrose injection in patients with moderate knee osteoarthritis: a single-arm study with 6 months follow up.Ther Adv Musculoskelet Dis,7,35-44.
6. Hashemi, M,Parviz, J,Mennati, S(2015).The effects of prolotherapy with hupertinic dextrose versus prolozone (interaarticular ozone) in patients with knee osteoarthritis.Anesth Pain Med,5,e27858.
7. Hauser, RA,Hauser, MA,Baird, NM(2011).Evidence-based use of dextrose prolotherapy for musculoskeletal pain: a scientific literature review.Journal of Prolotherapy,3,765-789.
8. Hauser, RA,Lackner, JB,Steilen-Matias, D(2016).A systematic review of dextrose prolotherapy for chronic musculoskeletal pain.Clin Med Insights Arthritis Musculoskelet Disord,9,139-159.
9. Jahangiri, A,Moghaddam, FR,Najafi, S(2014).Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial.J Orthop Sci,19,737-743.
10. Khan, SA,Kumar, A,Varshney, MK(2008).Dextrose prolotherapy for recalcitrant coccygodynia.J Orthop Surg,16,27-29.
11. Kim, HS,Jung, KH,Park, IH(2007).Diagnosis and treatment of sacral asymlocation in back pain patients.Korean J Pain,20,130-137.
12. Kim, WM,Lee, HG,Jeong, CW(2010).A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain.J Altern Complement Med,16,1285-1290.
13. Lee, DH,Kwack, KS,Rah, UW(2015).Prolotherapy for refractory rotator cuff disease: retrospective case-control study of 1-year follow-up.Arch Phys Med Rehabil,96,2027-2032.
14. Lee, JD,Lee, DW,Cheol, Won, J(2009).Effects of intraarticular prolotherapy on sacroiliac joint pain.Korean J Pain,22,229-233.
15. Lyftogt, J(2005).Prolotherapy and Achilles tendinopathy: a prospective pilot study of an old treatment.Aust Musculoskel Med J,10,16-19.
16. Maxwell, NJ,Ryan, MB,Taunton, JE(2007).Sonographically guided intratendinous injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: a pilot study.AJR Am J Roentgenol,189,w215-w220.
17. Park, JH,Song, IS,Lee, JB(2003).Ultrasonographic findings of healing of torn tendon in the patients with lateral epicondylitis after prolotherapy.J Korean Soc Med Ultrasound,22,177-183.
18. Rabago, D,Mundt, M,Zgierska, A(2015).Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: long term outcomes.Complement Ther Med,23,388-395.
19. Rabago, D,Patterson, JJ,Mundt, M(2013).Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial.Ann Fam Med,11,229-237.
20. Rabago, D,Slattengren, A,Zgierska, A(2010).Prolotherapy in primary care practice.Prim Care,37,65-80.
21. Reeves, KD,Hassanein, K(2000).Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP,PIP, and Trapeziometacarpal) joints: evidence of clinical efficacy.J Altern Complement Med,6,311-320.
22. Reeves, KD,Hassanein, K(2000).Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity.Altern Ther Health Med,6,68-79.
23. Reeves, KD,Hassanein, KM(2003).Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity.Altern Ther Health Med,9,58-62.
24. Reeves, KD,Sit, RW,Rabago, DP(2016).Dextrose prolotherapy: a narrative review of basic science, clinical research, and best treatment recommendations.Phys Med Rehabil Clin N Am,27,783-823.
25. Refai, H,Altahhan, O,Elsharkawy, R(2011).the efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial.J Oral Maxillofac Sur,69,2962-2970.
26. Ryan, M,Wong, A,Rabago, D(2011).Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study.Br J Sports Med,45,972-977.
27. Scarpone, M,Rabago, DP,Zgierska, A(2008).The efficacy of prolotherapy for lateral epicondylosis: a pilot study.Clin J Sport Med,18,248-254.
28. Shin, J,Seo, K-M,Kim, D-K(2002).The effect of prolotherapy on lateral epicondylitis of elbow.J Korean Acad Rehabil Med,26,764-768.
29. Topol, GA,Podesta, LA,Reeves, KD(2011).Hyperosmolar dextrose injection for recalcitrant Osgood-Schlatter disease.Pediatrics,128,e1121-e1128.
30. Topol, GA,Reeves, KD(2008).Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series.Am J Phys Med Rehabil,87,890-902.
31. Topol, GA,Reeves, KD,Hassanein, KM(2005).Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain.Arch Phys Med Rehabil,86,697-702.
32. Yelland, MJ,Sweeting, KR,Lyftogt, JA(2011).Pfrolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial.Br J Sports Med,45,421-428.

1. 蔡德祥,陳朝龍,林源泉(2021)。針刀拔罐療法之探討。中醫藥研究論叢，24(4)，69-76。