Straube Sebastian, Derry Sheena, Moore R Andrew, McQuay Henry J
Department of Occupational and Social Medicine, University of Göttingen, Waldweg 37 B, Göttingen, Germany, D-37073.
Cochrane Database Syst Rev. 2010 Jan 20(1):CD007771. doi: 10.1002/14651858.CD007771.pub2.
Vitamin D is produced in the skin after sun-light exposure and can also be obtained through food. Vitamin D deficiency has recently been linked with a range of diseases including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic pain conditions.
To assess the efficacy and adverse events of vitamin D supplementation in chronic painful conditions.
We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to September 2009. This was supplemented by searching the reference lists of retrieved articles, textbooks and reviews.
Studies were included if they were randomised double blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic pain conditions in adults.
Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. Pooled analysis was not undertaken due to paucity and heterogeneity of data.
Four studies, with a total of 294 participants, were included. The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, and the outcome measures reported. Only one study reported a beneficial effect, the others found no benefit of vitamin D over placebo in treating chronic pain.
AUTHORS' CONCLUSIONS: The evidence base for the use of vitamin D for chronic pain in adults is poor at present. This is due to low quality and insufficient randomised controlled trials in this area of research.
维生素D在皮肤经阳光照射后产生,也可通过食物获取。近期研究发现维生素D缺乏与包括慢性疼痛在内的一系列疾病有关。观察性和间接证据表明,维生素D缺乏可能在慢性疼痛性疾病的病因中起作用。
评估补充维生素D治疗慢性疼痛性疾病的疗效和不良事件。
我们检索了考克兰中央对照试验注册库、医学期刊数据库、荷兰医学文摘数据库以及牛津疼痛缓解数据库,检索截至2009年9月的研究。此外,还通过检索所获文章、教科书和综述的参考文献列表进行补充。
纳入的研究需为维生素D补充剂与安慰剂或活性对照物对比治疗成人慢性疼痛性疾病的随机双盲试验。
两位综述作者独立选择纳入研究,评估方法学质量并提取数据。由于数据匮乏和异质性,未进行汇总分析。
共纳入4项研究,总计294名参与者。这些研究在研究质量、所调查的慢性疼痛性疾病以及报告的结局指标方面存在异质性。只有一项研究报告了有益效果,其他研究发现维生素D在治疗慢性疼痛方面并不比安慰剂更有效。
目前,关于成人慢性疼痛使用维生素D的证据基础薄弱。这是由于该研究领域的随机对照试验质量较低且数量不足。