Ardiç Füsum, Ozgen Merih, Aybek Hülya, Rota Simin, Cubukçu Duygu, Gökgöz Ali
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
Rheumatol Int. 2007 Mar;27(5):441-6. doi: 10.1007/s00296-006-0237-x.
The purpose of this study was to investigate the clinical effects of balneotherapy in the treatment of Fibromyalgia Syndrome (FMS) and to determine if balneotherapy influences serum levels of inflammation markers, IL-1, PGE2 and LTB4. 24 primary fibromyalgia female patients diagnosed according to American College of Rheumatology criteria were included to the study. Their ages ranged between 33 and 55 years. FMS patients were randomly assigned in two groups as, group 1 (n = 12) and group 2 (n = 12). Group 1 received 20-min bathing, once in a day for five days per week. Patients participated in the study for 3 weeks (total of 15 sessions) in Denizli. Group 2 did not receive balneotherapy. FMS patients were evaluated by tenderness measurements (tender point count and algometry), Visual Analogue Scale, Beck's Depression Index, Fibromyalgia Impact Questionnaire. Ten healthy women recruited group three as the controls. Serum PGE2, LTB4 and IL1-alpha levels were measured in all three groups. The biochemical measurements and clinical assessments were performed before and at the end of general period of therapy. Statistically significant alterations in algometric score, Visual Analogue score, Beck's Depression Index and PGE2 levels (P < 0.001), numbers of tender points (P < 0.01) and Fibromyalgia Impact Questionnaire score (P < 0.05) were found after the balneotherapy between group 1 and 2. Mean PGE2 level of FMS patients were higher compared to healthy control group (P < 0.0001) and decreased after the treatment period, only in group 1 (P < 0.05). As in the group 2 and 3, detectable IL-1 and LTB4 measurements were insufficient, statistical analysis was performed, only in group 1. After balneotherapy IL-1 and LTB4 significantly decreased in group 1 (P < 0.05). In conclusion, balneotherapy is an effective choice of treatment in patients with FMS relieving the clinical symptoms, and possibly influencing the inflammatory mediators.
本研究旨在探讨温泉疗法治疗纤维肌痛综合征（FMS）的临床效果，并确定温泉疗法是否会影响炎症标志物白细胞介素-1（IL-1）、前列腺素E2（PGE2）和白三烯B4（LTB4）的血清水平。根据美国风湿病学会标准诊断的24例原发性纤维肌痛女性患者纳入本研究。她们的年龄在33岁至55岁之间。FMS患者被随机分为两组，即第1组（n = 12）和第2组（n = 12）。第1组接受20分钟的沐浴，每周5天，每天1次。患者在代尼兹利参加了3周的研究（共15次疗程）。第2组未接受温泉疗法。通过压痛测量（压痛点计数和痛觉测量）、视觉模拟评分、贝克抑郁指数、纤维肌痛影响问卷对FMS患者进行评估。招募了10名健康女性作为第3组作为对照。测量了所有三组患者的血清PGE2、LTB4和IL-1α水平。在治疗总疗程开始前和结束时进行生化测量和临床评估。第1组和第2组在温泉疗法后，痛觉测量评分、视觉模拟评分、贝克抑郁指数和PGE2水平出现具有统计学意义的改变（P < 0.001），压痛点数量（P < 0.01）和纤维肌痛影响问卷评分（P < 0.05）。与健康对照组相比，FMS患者的平均PGE2水平更高（P < 0.0001），仅在第1组治疗期后有所下降（P < 0.05）。由于第2组和第3组中可检测到的IL-1和LTB4测量值不足，仅在第1组进行了统计分析。温泉疗法后，第1组的IL-1和LTB4显著下降（P < 0.05）。总之，温泉疗法是FMS患者缓解临床症状、可能影响炎症介质的一种有效治疗选择。
