对于急性下背痛，持续低水平热裹疗法比布洛芬和对乙酰氨基酚更有效。

Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain.

作者信息

Nadler Scott F, Steiner Deborah J, Erasala Geetha N, Hengehold David A, Hinkle Robert T, Beth Goodale Mary, Abeln Susan B, Weingand Kurt W

机构信息

Department of Physical Medicine and Rehabilitation, UMDNJ-NJ Medical School, the; Research Testing Laboratories, Newark, NJ 07103, USA.

出版信息

Spine (Phila Pa 1976). 2002 May 15;27(10):1012-7. doi: 10.1097/00007632-200205150-00003.

DOI:10.1097/00007632-200205150-00003

PMID:12004166

Abstract

STUDY DESIGN

A prospective, randomized, single (investigator) blind, comparative efficacy trial was conducted.

OBJECTIVE

To compare the efficacy of continuous low-level heat wrap therapy (40 C, 8 hours/day) with that of ibuprofen (1200 mg/day) and acetaminophen (4000 mg/day) in subjects with acute nonspecific low back pain.

SUMMARY OF BACKGROUND DATA

The efficacy of topical heat methods, as compared with oral analgesic treatment of low back pain, has not been established.

METHODS

Subjects (n = 371) were randomly assigned to heat wrap (n = 113), acetaminophen (n = 113), or ibuprofen (n = 106) for efficacy evaluation, or to oral placebo (n = 20) or unheated back wrap (n = 19) for blinding. Outcome measures included pain relief, muscle stiffness, lateral trunk flexibility, and disability. Efficacy was measured over two treatment days and two follow-up days.

RESULTS

Day 1 pain relief for the heat wrap (mean, 2) was higher than for ibuprofen (mean, 1.51; P = 0.0007) or acetaminophen (mean, 1.32; P = 0.0001). Extended mean pain relief (Days 3 to 4) for the heat wrap (mean, 2.61) also was higher than for ibuprofen (mean, 1.68; P = 0.0001) or acetaminophen (mean, 1.95; P = 0.0009). Lateral trunk flexibility was improved with the heat wrap (mean change, 4.28 cm) during treatment (P </= 0.009 vs acetaminophen [mean change, 2.93 cm], P </= 0.001 vs ibuprofen [mean change, 2.51 cm]). The results were similar on Day 4. Day 1 reduction in muscle stiffness with the heat wrap (mean, 16.3) was greater than with acetaminophen (mean, 10.5; P = 0.001). Disability was reduced with the heat wrap (mean, 4.9), as compared with ibuprofen (mean, 2.7; P = 0.01) and acetaminophen (mean, 2.9; P = 0.0007), on Day 4. None of the adverse events were serious. The highest rate (10.4%) was reported in the ibuprofen group.

CONCLUSION

Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain.

摘要

研究设计

进行了一项前瞻性、随机、单（研究者）盲、比较疗效试验。

目的

比较连续低水平热裹疗法（40摄氏度，每天8小时）与布洛芬（每天1200毫克）和对乙酰氨基酚（每天4000毫克）治疗急性非特异性下腰痛患者的疗效。

背景数据总结

与口服镇痛药治疗下腰痛相比，局部热疗方法的疗效尚未确定。

方法

将受试者（n = 371）随机分配至热裹组（n = 113）、对乙酰氨基酚组（n = 113）或布洛芬组（n = 106）进行疗效评估，或分配至口服安慰剂组（n = 20）或未加热的背部裹敷组（n = 19）进行盲法对照。观察指标包括疼痛缓解、肌肉僵硬、侧躯干柔韧性和功能障碍。在两个治疗日和两个随访日测量疗效。

结果

热裹组第1天的疼痛缓解程度（平均值为2）高于布洛芬组（平均值为1.51；P = 0.0007）和对乙酰氨基酚组（平均值为1.32；P = 0.0001）。热裹组延长的平均疼痛缓解程度（第3至4天，平均值为2.61）也高于布洛芬组（平均值为1.68；P = 0.0001）和对乙酰氨基酚组（平均值为1.95；P = 0.0009）。治疗期间热裹组的侧躯干柔韧性得到改善（平均变化4.28厘米）（与对乙酰氨基酚组相比，P≤0.009[平均变化2.93厘米]；与布洛芬组相比，P≤0.001[平均变化2.51厘米]）。第4天的结果相似。热裹组第1天肌肉僵硬程度的降低（平均值为16.3）大于对乙酰氨基酚组（平均值为10.5；P = 0.001）。与布洛芬组（平均值为2.7；P = 0.01）和对乙酰氨基酚组（平均值为2.9；P = 0.0007）相比，热裹组在第4天功能障碍程度降低。所有不良事件均不严重。布洛芬组报告的发生率最高（10.4%）。