Hirvonen H E, Mikkelsson M K, Kautiainen H, Pohjolainen T H, Leirisalo-Repo M
Rheumatism Foundation Hospital, Heinola, Finland.
Clin Exp Rheumatol. 2006 May-Jun;24(3):295-301.
Local cryotherapy is used to relieve pain and inflammation in injuries and inflammatory conditions. Whole-body cryotherapy is an extreme method administered at -110 degrees C for 2 to 3 minutes. The aim of the study was to compare the effect of cryotherapies on pain and inflammation in patients with rheumatoid arthritis (RA).
Sixty patients with active seropositive RA were recruited in a randomised controlled single-blinded study to receive whole-body cryotherapy at -110 degrees C, whole-body cryotherapy at -60 degrees C, application of local cold air at -30 degrees C and the use of cold packs locally. In the final analysis, the last 2 groups were pooled. The patients had 2-3 cryotherapy sessions daily for one week plus conventional physiotherapy. Clinical and laboratory variables and patient's and physician's global assessments were used to assess the outcome. Disease activity was calculated by DAS.
Pain decreased in all treatment groups, most markedly in the whole-body cryotherapy (-110 degrees C) group. DAS decreased slightly with no statistically significant differences between the groups. No serious or permanent adverse effects were detected. Six of 40 patients (15%) discontinued the whole-body cryotherapy.
Pain seemed to decrease more in patients in the whole-body cryotherapy at -110 degrees C than during other cryotherapies, but there were no significant differences in the disease activity between the groups. However, cryotherapy at -110 degrees C is expensive and available only in special centres and may have minor adverse effects. Based on our results, whole-body cryotherapy at -110 degrees C is not superior to local cryotherapy commonly used in RA patients for pain relief and as an adjunct to physiotherapy.
局部冷冻疗法用于缓解损伤及炎症性病症中的疼痛和炎症。全身冷冻疗法是一种在-110摄氏度下进行2至3分钟的极端疗法。本研究的目的是比较冷冻疗法对类风湿关节炎（RA）患者疼痛和炎症的影响。
在一项随机对照单盲研究中招募了60例血清学阳性的活动性RA患者，分别接受-110摄氏度的全身冷冻疗法、-60摄氏度的全身冷冻疗法、-30摄氏度的局部冷空气疗法以及局部使用冷敷袋。在最终分析中，将最后两组合并。患者每天进行2至3次冷冻治疗，持续一周，并辅以传统物理治疗。使用临床和实验室变量以及患者和医生的整体评估来评估结果。通过疾病活动评分（DAS）计算疾病活动度。
所有治疗组的疼痛均有所减轻，其中以全身冷冻疗法（-110摄氏度）组最为明显。DAS略有下降，各治疗组之间无统计学显著差异。未检测到严重或永久性不良反应。40例患者中有6例（15%）停止了全身冷冻疗法。
与其他冷冻疗法相比，-110摄氏度的全身冷冻疗法似乎能使患者疼痛减轻更多，但各治疗组之间的疾病活动度无显著差异。然而，-110摄氏度的冷冻疗法费用昂贵，仅在特殊中心才可进行，且可能有轻微不良反应。根据我们的研究结果，-110摄氏度的全身冷冻疗法在缓解RA患者疼痛及作为物理治疗辅助手段方面并不优于常用的局部冷冻疗法。
