It's trivial to set up and thoroughly worth it. A lot can be accomplished with SQL scripts but significantly more can be accomplished with a scripting language that easily integrates with your database.
On linux? Use yum or apt. Windows?
http://www.wampserver.com/en/
With as many issues as a server admin faces I can't imagine not having some kind of command line scripting language available.
As an example that's more in line with your question, one of my biggest content changes is level-scaled world loot using the entire PEQ items table. It's all a set of scripts that I can run on a fresh database to score and distribute whatever items are in that DB release.
I also have some NPC and item libraries in the works for the purpose of automatically fixing ID's in the various spawn tables or quickly identifying and resolving item conflicts by overwriting or re-inserting and returning the new ID's.
Ideally I would like to define all of my content in one main script file using objects that can at least generate the appropriate new insert SQL and return ID's Then all I have to do is update my quest scripts. From that angle I could make a quest plugin that translates all my custom items by short name to ID, and then my script can just update the custom item plugin and all the quest scripts can reference $items{'fancy_helmet_1'} instead of 119899.
By the time I realized what I should have been doing to track my custom stuff, I was already pretty invested, which is why this tool exists, but moving forward I don't see a good way to future-proof your content without custom software of some kind.
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