Katsuragi Hospital, 250 Makamicho, Kishiwada, Osaka 596-0842, Japan.
J Bone Miner Metab. 2010 Jul;28(4):477-84. doi: 10.1007/s00774-009-0155-6. Epub 2010 Feb 16.
To assess the effect of raloxifene on bone and joint pain, 24 postmenopausal women with back or knee pain or both were randomly divided into two groups, based on the chronological sequence of consultation, to be treated with 60 mg raloxifene and 1 microg alfacalcidol (RA)/day (group RA) or 1 microg alfacalcidol alone (A)/day (group A), respectively, for 6 months. Pain following knee loading (KL) by standing up from a chair and bending the knee by squatting, knee and spine loading (KSL) by walking horizontally and ascending and descending stairs, and spine loading (SL) by lying down supine on a bed and leaving the bed to stand was evaluated by electroalgometry (EAM), based on measurement of the fall of skin impedance, and a visual rating scale (VRS), recording subjective pain on a scale of 0-100 between no pain and unbearable pain. The two groups showed no significant difference as to age, indices of mineral metabolism, back and knee pain, and bone status. RA gave a significantly greater analgesic effect than A by both EAM (P = 0.0158) and VRS (P = 0.0268) on overall comparison of the mean response to all modalities of exercise loading. Paired comparison between pretreatment and posttreatment indicated a significant effect of RA by both EAM (P = 0.0045) and VRS (P = 0.0017), but not that of A. The analgesic effect was more clearly noted on combined knee-spine loading (KSL) and spine loading (SL) than simple knee loading (KL). Monthly comparison of the analgesic effect indicated a significantly better analgesic effect in the fifth month by VRS. RA effect greater than A was more evident by EAM than VRS and during months 3-6 than during 1-2 months, suggesting a slowly progressive effect of RA. Pain evaluation by EAM and VRS mostly gave parallel results, except for a few occasions such as knee loading and spine loading by sitting up and leaving a bed, when EAM detected a positive effect but VRS failed to do so. RA appeared to be more effective on bone and joint pain than A in postmenopausal women according to both EAM and VRS measurements.
为了评估雷洛昔芬对骨骼和关节疼痛的影响，24 名有背部或膝盖疼痛或两者兼有、处于绝经后的女性，根据就诊的先后顺序，随机分为两组，分别接受 60mg 雷洛昔芬和 1 微克阿尔法骨化醇（RA）/天（RA 组）或单独 1 微克阿尔法骨化醇（A）/天（A 组）治疗，为期 6 个月。通过从椅子上站起来和蹲下时膝盖的负荷（KL）、水平行走、上下楼梯时膝盖和脊柱的负荷（KSL）以及仰卧在床上和起床时脊柱的负荷（SL），用电子肌电图（EAM）评估，基于皮肤阻抗下降的测量，以及视觉评分量表（VRS），记录疼痛的主观程度，范围为 0-100，从无痛到无法忍受的疼痛。两组在年龄、矿物质代谢指标、背部和膝盖疼痛以及骨骼状况方面没有显著差异。RA 在 EAM（P=0.0158）和 VRS（P=0.0268）上均显示出比 A 更大的镇痛效果，对所有运动负荷模式的平均反应进行整体比较。治疗前后的配对比较表明，RA 在 EAM（P=0.0045）和 VRS（P=0.0017）上均有显著效果，但 A 没有。RA 的镇痛效果在膝关节-脊柱联合负荷（KSL）和脊柱负荷（SL）上比单纯膝关节负荷（KL）更明显。镇痛效果的每月比较表明，VRS 在第五个月的镇痛效果显著改善。EAM 显示 RA 的效果优于 A，3-6 个月优于 1-2 个月，表明 RA 的效果逐渐增强。EAM 和 VRS 的疼痛评估结果大多相似，但在某些情况下，如从坐姿站起和离开床时的膝关节和脊柱负荷，EAM 检测到阳性效果，但 VRS 未能做到。根据 EAM 和 VRS 的测量结果，RA 似乎比 A 更有效治疗绝经后妇女的骨骼和关节疼痛。
