Tüzün Fikret, Unalan Halil, Oner Nazan, Ozgüzel Hayri, Kirazli Yeşim, Içağasioğlu Afitap, Kuran Banu, Tüzün Sansin, Başar Günnur
Department of Physical Medicine and Rehabilitation, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
Joint Bone Spine. 2003 Sep;70(5):356-61. doi: 10.1016/s1297-319x(03)00075-7.
To evaluate the efficacy of intramuscular injection of thiocolchicoside (4 mg-2 ml) compared to placebo administered twice daily for 5 days in patients suffering from acute low back pain.
Multicenter, randomized, double-blinded, placebo-controlled trial. The study was conducted between July 1998 and March 2000 in five centers. Hospitalized patients with acute low back pain were included. The primary evaluation criterion was spontaneous pain at rest assessed by visual analog scale (VAS). Hand-to-floor distance, muscle spasm intensity, patients' global evaluation and analgesic tablet (paracetamol) consumption were used as secondary evaluation criteria.
One hundred and forty nine patients were included. Both groups showed improvement on spontaneous pain assessed by VAS at the end of day 1; however, improvement was statistically significant in thiocolchicoside group on day 3 (P < 0.001). Hand-to-floor distance and muscle spasm determined by palpation decreased significantly on day 5 in thiocolchicoside group (P < 0.0005 for both). According to the patients' global evaluation, 76.8% of patients in thiocolchicoside group evaluated the treatment as very good/good (P < 0.0005). Also a significant difference was observed in favor of the thiocolchicoside group in the total paracetamol consumption (P < 0.001). Treatment was well tolerated in both groups and none of the patients was withdrawn from the study due to an adverse effect.
Twice daily administration of 4 mg thiocolchicoside for 5 days provides an efficient and safe treatment for patients with acute low back pain accompanied by muscle spasm.
评估在急性下背痛患者中,每日两次肌肉注射秋水仙碱硫代糖苷(4毫克 - 2毫升)与安慰剂相比,连续5天给药的疗效。
多中心、随机、双盲、安慰剂对照试验。该研究于1998年7月至2000年3月在五个中心进行。纳入住院的急性下背痛患者。主要评估标准是通过视觉模拟量表(VAS)评估的静息时自发疼痛。手触地距离、肌肉痉挛强度、患者整体评估和止痛片(对乙酰氨基酚)消耗量用作次要评估标准。
共纳入149例患者。两组在第1天结束时通过VAS评估的自发疼痛均有改善;然而,秋水仙碱硫代糖苷组在第3天的改善具有统计学意义(P < 0.001)。秋水仙碱硫代糖苷组在第5天时,手触地距离和触诊确定的肌肉痉挛显著降低(两者均P < 0.0005)。根据患者的整体评估,秋水仙碱硫代糖苷组76.8%的患者将治疗评价为非常好/好(P < 0.0005)。在对乙酰氨基酚总消耗量方面也观察到有利于秋水仙碱硫代糖苷组的显著差异(P < 0.001)。两组治疗耐受性良好,没有患者因不良反应退出研究。
每日两次给予4毫克秋水仙碱硫代糖苷,连续5天,为伴有肌肉痉挛的急性下背痛患者提供了一种有效且安全的治疗方法。