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静脉注射微量营养素疗法(迈尔斯鸡尾酒疗法)治疗纤维肌痛:一项安慰剂对照的试点研究。

Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study.

作者信息

Ali Ather, Njike Valentine Yanchou, Northrup Veronika, Sabina Alyse B, Williams Anna-Leila, Liberti Lauren S, Perlman Adam I, Adelson Harry, Katz David L

机构信息

Prevention Research Center, Yale University School of Medicine, Derby, CT 06418, USA.

出版信息

J Altern Complement Med. 2009 Mar;15(3):247-57. doi: 10.1089/acm.2008.0410.

Abstract

OBJECTIVES

Intravenous micronutrient therapy (IVMT), and specifically the Myers' Cocktail, is a popular approach for treating fibromyalgia syndrome (FMS) among complementary and alternative medicine practitioners, but its efficacy is uncertain. This trial assessed the feasibility, safety, and provided insights into the efficacy of this therapy.

DESIGN

This was a randomized, double-blind, placebo-controlled pilot study.

LOCATIONS

The study locations were an academic research center, teaching hospital, and affiliated Integrative Medicine Center in Derby, CT.

SUBJECTS

The subjects were 34 adults with American College of Rheumatology (ACR)-defined FMS.

INTERVENTION

Subjects were randomly assigned either to treatment (weekly infusions of IVMT) or to placebo (weekly infusions of lactated Ringer's solution) for 8 weeks.

OUTCOME MEASURES

Primary outcome was change in the Tender Point Index, assessed 8 and 12 weeks after initiation. Secondary measures included a Visual Analog Scale to assess global pain, and validated measures of physical function (Fibromyalgia Impact Questionnaire), mood (Beck Depression Index), and quality of life (Health Status Questionnaire 2.0).

RESULTS

Clinically significant improvements were noted (of a magnitude similar to other effective interventions). However, in part because of the high placebo response and the small sample size, no statistically significant differences were seen between groups, in any outcome measure, at 8 and 16 weeks. Statistically significant within-group differences were seen in both the intervention and placebo groups, demonstrating a treatment effect for both IVMT and placebo. At 8 weeks, the IVMT group experienced significantly improved tender points, pain, depression, and quality of life directly following treatment (all p < or = 0.02), while the placebo group experienced significantly improved tender points only (p < or = 0.05). The treatment effects of IVMT persisted at 4 weeks postintervention for tender points, pain, and quality of life, while placebo effects persisted only for tender points. A single minor adverse event was noted in one subject in the intervention group.

CONCLUSIONS

This first controlled pilot study established the safety and feasibility of treating FMS with IVMT. Most subjects experienced relief as compared to baseline, but no statistically significant differences were seen between IVMT and placebo. The efficacy of IVMT for fibromyalgia, relative to placebo, is as yet uncertain.

摘要

目的

静脉微量营养素疗法(IVMT),尤其是迈尔斯鸡尾酒疗法,是补充和替代医学从业者中治疗纤维肌痛综合征(FMS)的常用方法,但其疗效尚不确定。本试验评估了该疗法的可行性、安全性,并对其疗效进行了深入研究。

设计

这是一项随机、双盲、安慰剂对照的试点研究。

地点

研究地点为康涅狄格州德比的一个学术研究中心、教学医院及附属综合医学中心。

受试者

受试者为34名患有美国风湿病学会(ACR)定义的FMS的成年人。

干预措施

受试者被随机分配接受治疗(每周静脉输注IVMT)或安慰剂(每周静脉输注乳酸林格氏液),为期8周。

观察指标

主要观察指标为压痛点指数的变化,在开始治疗后8周和12周进行评估。次要指标包括用于评估总体疼痛的视觉模拟量表,以及经过验证的身体功能(纤维肌痛影响问卷)、情绪(贝克抑郁量表)和生活质量(健康状况问卷2.0)测量指标。

结果

观察到有临床意义的改善(改善程度与其他有效干预措施相似)。然而,部分由于高安慰剂反应和小样本量,在8周和16周时,两组在任何观察指标上均未观察到统计学上的显著差异。在干预组和安慰剂组中均观察到组内有统计学意义的差异,表明IVMT和安慰剂均有治疗效果。在8周时,IVMT组在治疗后直接出现压痛点、疼痛、抑郁和生活质量的显著改善(所有p≤0.02),而安慰剂组仅压痛点有显著改善(p≤0.05)。IVMT对压痛点、疼痛和生活质量的治疗效果在干预后4周持续存在,而安慰剂效果仅在压痛点持续存在。干预组有一名受试者出现了一起轻微不良事件。

结论

这项首次对照试点研究确定了IVMT治疗FMS的安全性和可行性。与基线相比,大多数受试者症状得到缓解,但IVMT组和安慰剂组之间未观察到统计学上的显著差异。相对于安慰剂,IVMT治疗纤维肌痛的疗效尚不确定。

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