Department of Gynaecology, Obstetric and Reproductive Science, Second University of Studies of Naples, Largo Madonna delle Grazie 1, 80138 Naples, Italy.
Eur J Obstet Gynecol Reprod Biol. 2011 Sep;158(1):82-6. doi: 10.1016/j.ejogrb.2011.04.011. Epub 2011 May 23.
Aim of our study was to evaluate the effectiveness of the association between N-Palmitoylethanolamine and transpolydatin in the management of chronic pelvic pain related to EMS.
This was a randomized, double-blind, parallel-group, placebo-controlled clinical trial involving 61 subjects, submitted to a first line laparoscopic conservative surgery, who were randomized into 3 groups receiving: group A (n=21) the association N-Palmitoylethanolamine-transpolydatin 400 mg + 40 mg twice a day for 3 months; group B (n=20) the placebo for 3 months; group C (n=20) a single course of Celecoxib 200mg twice a day for 7 consecutive days. Assessments of the severity of pelvic endometriosis (pelvic pain, dysmenorrhoea and dyspareunia) were recorded before and after treatment on a questionnaire and a 10-point VAS. Differences between groups were verified with Kruskal-Wallis ANOVA for non-parametric multiple comparisons.
A marked decrease in dysmenorrhoea, dyspareunia and pelvic pain was observed in all groups, and the association between N-Palmitoylethanolamine and transpolydatin resulted to be more effective than placebo (P<.001). Additionally, the treatment with Celecoxib resulted in a decrease in pelvic pain more effective either than the association N-Palmitoylethanolamine and transpolydatin or placebo.
These preliminary results show that the association between micronized N-Palmitoylethanolamine and transpolydatin is effective in the management of pelvic pain related to endometriosis after laparoscopy. Additionally, this association seems to be safe, shows an optimal control of pain and can be used in patients who are unable to receive other therapies.
我们研究的目的是评估 N-棕榈酰乙醇胺与虎杖苷联合应用在治疗慢性盆腔痛相关 EMS 中的有效性。
这是一项随机、双盲、平行组、安慰剂对照的临床试验,涉及 61 名接受一线腹腔镜保守手术的受试者,他们被随机分为 3 组,分别接受以下治疗:A 组(n=21),联合使用 N-棕榈酰乙醇胺-虎杖苷 400mg+40mg,每日两次,疗程 3 个月;B 组(n=20),安慰剂治疗 3 个月;C 组(n=20),塞来昔布单疗程 200mg,每日两次,连续 7 天。治疗前后通过问卷和 10 分视觉模拟评分(VAS)评估盆腔子宫内膜异位症的严重程度。使用 Kruskal-Wallis ANOVA 进行非参数多重比较,以验证组间差异。
所有组的痛经、性交痛和盆腔痛均显著减轻,N-棕榈酰乙醇胺与虎杖苷联合治疗比安慰剂更有效(P<.001)。此外,塞来昔布治疗可更有效地减轻盆腔痛,优于 N-棕榈酰乙醇胺与虎杖苷联合治疗或安慰剂。
这些初步结果表明,微粉化 N-棕榈酰乙醇胺与虎杖苷联合应用在腹腔镜治疗后治疗子宫内膜异位症相关盆腔痛是有效的。此外,这种联合治疗似乎安全,能很好地控制疼痛,可用于不能接受其他治疗的患者。