Brüggemann G, Koehler C O, Koch E M
Weserberglandklinik, Höxter.
Klin Wochenschr. 1990 Jan 19;68(2):116-20. doi: 10.1007/BF01646858.
Several clinical trials have shown that the duration of treatment of painful vertebral syndromes can be shortened by using a combination of vitamins B1, B6, B12 and diclofenac instead of diclofenac. In addition, a more efficient pain relief could be achieved by the combination therapy. In order to confirm these results, we compared the clinical efficacy of diclofenac (25 mg) and a combination preparation with diclofenac (25 mg) plus vitamins B1 (thiamine nitrate 50 mg), B6 (pyridoxine hydrochloride 50 mg) and B12 (cyanocobalamin 0.25 mg) in a multicentric randomized double-blind study including 418 patients. All patients received 3 x 2 capsules daily for a maximum of 2 weeks. In case of total pain relief, therapy should be discontinued after one week. Data of 376 patients could be evaluated. 53 out of 184 patients receiving the combination and 48 out of 192 patients treated with diclofenac alone could stop therapy due to sufficient pain relief after one week. The evaluation of the "Hoppe Pain Questionnaire" and the data concerning pain intensity also revealed better results for the combination preparation. The differences in favour of the B-vitamin-diclofenac-combination were statistically significant in patients with severe pain at the beginning of therapy. Considering undesirable side-effects (symptoms in 70 out of 418 patients) there were no significant differences between the two medications. This clinical trial provides further evidence that the combination therapy with diclofenac plus B-vitamins is more effective than diclofenac alone for the treatment of painful vertebral syndromes.
多项临床试验表明,使用维生素B1、B6、B12与双氯芬酸的组合而非单独使用双氯芬酸,可缩短疼痛性脊椎综合征的治疗时间。此外,联合治疗能实现更有效的疼痛缓解。为证实这些结果,我们在一项纳入418例患者的多中心随机双盲研究中,比较了双氯芬酸(25毫克)与双氯芬酸(25毫克)加维生素B1(硝酸硫胺50毫克)、B6(盐酸吡哆醇50毫克)和B12(氰钴胺0.25毫克)的复方制剂的临床疗效。所有患者每天服用3次,每次2粒胶囊,最长服用2周。若疼痛完全缓解,1周后应停止治疗。376例患者的数据可进行评估。接受联合治疗的184例患者中有53例,单独使用双氯芬酸治疗的192例患者中有48例,因1周后疼痛得到充分缓解而可停止治疗。“霍普疼痛问卷”的评估以及有关疼痛强度的数据也显示复方制剂的效果更佳。在治疗开始时疼痛严重的患者中,维生素B - 双氯芬酸组合的优势差异具有统计学意义。考虑到不良副作用(418例患者中有70例出现症状),两种药物之间没有显著差异。这项临床试验进一步证明,双氯芬酸加维生素B的联合治疗在治疗疼痛性脊椎综合征方面比单独使用双氯芬酸更有效。