Rampp Thomas, Michalsen Andreas, Lüdtke Rainer, Musial Frauke, Kremer Gerd, Dobos Gustav J
Innere Medizin V, Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte/Knappschafts-Krankenhaus, Essen, Deutschland.
Forsch Komplementmed. 2009 Aug;16(4):246-50. doi: 10.1159/000228654. Epub 2009 Jul 30.
Lumbar spinal stenosis (LSS) is a common cause of chronic lumbar pain and disability. Conventional therapy approaches include analgesics and spinal surgery. Topical cantharidin applications are used for the treatment of severe chronic lumbar pain in traditional European medicine (TEM). We tested the pain-relieving effect of lumbar cantharidin blisters in a non-randomised controlled pilot study.
28 consecutive patients with manifest LSS were included. The first 20 patients received a cantharidin blister, 8 patients served as controls (waiting list). Pain was assessed by means of a numeric visual analogue scale (VAS; 0 indicating no pain, 10 indicating strongest pain). Treatment started after a 3-day run-in phase, the blister was applied once for 12 h.
Patients were comparable with respect to baseline pain. In the blister group, the pain score continuously improved from 7.2 +/- 2.1 at baseline to 2.9 +/- 2.3 (VAS) at day 7, whereas the score remained unchanged in control patients. Adjusted for baseline, the difference between the blister and the control group was estimated at 4.1 (95% CI: 2.4-5.9, p < 0.0001). The use of analgesics was slightly higher in the control group. No serious adverse events were observed.
In this first study on the efficacy of cantharidin blisters, a clinically relevant pain-relieving short-term effect on LSS was observed. As the trial was non-randomised and only included a limited number of patients, the results should be interpreted with caution.
腰椎管狭窄症（LSS）是慢性腰痛和残疾的常见原因。传统治疗方法包括使用镇痛药和脊柱手术。在传统欧洲医学（TEM）中，外用斑蝥素用于治疗严重的慢性腰痛。我们在一项非随机对照试验性研究中测试了腰椎斑蝥素水疱贴的止痛效果。
纳入28例连续的明显LSS患者。前20例患者接受斑蝥素水疱贴治疗，8例患者作为对照组（等待名单）。通过数字视觉模拟量表（VAS；0表示无疼痛，10表示最剧烈疼痛）评估疼痛。在3天的导入期后开始治疗，水疱贴贴敷一次，持续12小时。
患者在基线疼痛方面具有可比性。水疱贴组的疼痛评分从基线时的7.2±2.1持续改善至第7天的2.9±2.3（VAS），而对照组患者的评分保持不变。经基线调整后，水疱贴组与对照组之间的差异估计为4.1（95%CI：2.4 - 5.9，p < 0.0001）。对照组使用镇痛药的比例略高。未观察到严重不良事件。
在这项关于斑蝥素水疱贴疗效的首次研究中，观察到其对LSS有临床相关的短期止痛效果。由于该试验是非随机的且仅纳入了有限数量的患者，结果应谨慎解读。
