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气压式压迫装置是治疗不宁腿综合征的一种有效疗法:一项前瞻性、随机、双盲、假对照试验。

Pneumatic compression devices are an effective therapy for restless legs syndrome: a prospective, randomized, double-blinded, sham-controlled trial.

作者信息

Lettieri Christopher J, Eliasson Arn H

机构信息

Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC.

Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC.

出版信息

Chest. 2009 Jan;135(1):74-80. doi: 10.1378/chest.08-1665. Epub 2008 Nov 18.

Abstract

BACKGROUND

Pharmacotherapy for restless legs syndrome (RLS) may be ineffective or complicated by side effects. Uncontrolled series using pneumatic compression devices (PCDs) have been shown to reduce symptoms of RLS. We sought to assess the efficacy of PCDs as a nonpharmacologic treatment for RLS.

METHODS

We performed a prospective, randomized, double-blinded, sham-controlled trial of individuals with RLS. Subjects wore a therapeutic or sham device prior to the usual onset of symptoms for a minimum of 1 h daily. Measures of severity of illness, quality of life, daytime sleepiness, and fatigue were compared at baseline and after 1 month of therapy.

RESULTS

Thirty-five subjects were enrolled. Groups were similar at baseline. Therapeutic PCDs significantly improved all measured variables more than shams. Restless Legs Severity Score improved from 14.1 +/- 3.9 to 8.4 +/- 3.4 (p = 0.006) and Johns Hopkins Restless Legs Scale improved from 2.2 +/- 0.5 to 1.2 +/- 0.7 (p = 0.01). All quality of life domains improved more with therapeutic than sham devices (social function 14% vs 1%, respectively; p = 0.03; daytime function 21% vs 6%, respectively, p = 0.02; sleep quality 16% vs 8%, respectively, p = 0.05; emotional well-being 17% vs 10%, respectively, p = 0.15). Both Epworth sleepiness scale (6.5 +/- 4.0 vs 11.3 +/- 3.9, respectively, p = 0.04) and fatigue (4.1 +/- 2.1 vs 6.9 +/- 2.0, respectively, p = 0.01) improved more with therapeutic devices than sham devices. Complete relief occurred in one third of subjects using therapeutic and in no subjects using sham devices.

CONCLUSION

PCDs resulted in clinically significant improvements in symptoms of RLS in comparison to the use of sham devices and may be an effective adjunctive or alternative therapy for RLS.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT00479531.

摘要

背景

不安腿综合征(RLS)的药物治疗可能无效或伴有副作用。使用气动压缩装置(PCD)的非对照系列研究已表明可减轻RLS症状。我们旨在评估PCD作为RLS非药物治疗方法的疗效。

方法

我们对RLS患者进行了一项前瞻性、随机、双盲、假对照试验。受试者在症状通常发作前佩戴治疗性或假装置,每天至少1小时。在基线和治疗1个月后比较疾病严重程度、生活质量、日间嗜睡和疲劳的测量指标。

结果

35名受试者入组。两组在基线时相似。治疗性PCD比假装置更显著地改善了所有测量变量。不安腿严重程度评分从14.1±3.9改善至8.4±3.4(p = 0.006),约翰霍普金斯不安腿量表从2.2±0.5改善至1.2±0.7(p = 0.01)。与假装置相比,治疗性装置使所有生活质量领域的改善更为明显(社会功能分别为14%对1%;p = 0.03;日间功能分别为21%对6%,p = 0.02;睡眠质量分别为16%对8%,p = 0.05;情绪健康分别为17%对10%,p = 0.15)。与假装置相比,治疗性装置使爱泼沃斯嗜睡量表评分(分别为6.5±4.0对11.3±3.9,p = 0.04)和疲劳程度(分别为 4.1±2.1对6.9±2.0,p = 0.01)的改善更为明显。使用治疗性装置的受试者中有三分之一完全缓解,而使用假装置的受试者无一人完全缓解。

结论

与使用假装置相比,PCD使RLS症状在临床上有显著改善,可能是RLS的一种有效辅助或替代疗法。

试验注册

Clinicaltrials.gov标识符:NCT00479531。

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