Department of Anesthesia, Intensive Care and Pain Therapy, Sacro Cuore Catholic University, Campobasso, Italy.
Minerva Med. 2012 Jun;103(3):143-9.
Many therapies exist for treatment of chronic low-back pain (LBP) including the use of muscle relaxant and analgesic drugs. The aim of this paper was to compare efficacy and tolerability of eperisone and tizanidine in combination treatment with tramadol in chronic LBP.
Sixty patients affected by chronic LBP associated with contractures of paravertebral muscles were randomized in two groups: Group E (30 patients) treated with eperisone; Group T (30 patients) treated with tizanidine. Both groups received tramadol retard 100 mg/day. VAS at rest and with effort were used at baseline (T0) and after 5 (T5), 10 (T10), 15 (T15) and 30 (T30) days of treatment. The Summed Pain Intensity Difference (SPID), the SPID percentage (SPID%) and the Total Pain Relief (TOTPAR), at rest (-r) and with effort (-e) were calculated.
In both groups a statistically significant reduction in VAS-r and VAS-e was observed during the treatment; similar reductions occurred in both groups at every timepoint. SPID-r and -e, SPID%-r and -e and TOTPAR-r and -e resulted similar between groups. A significant difference between groups occurred for incidence of somnolence: 16.6% for Group E versus 43.3% for Group T. Treatment was stopped due to adverse events in 5 patients of Group E and in 9 patients of Group T, without statistically significant difference.
Both associations assumed for one month, have shown effective for LBP at rest and with effort. Eperisone/tramadol, reducing discontinuation and allowing a better adherence to the therapy, may be considered a viable option for the treatment of chronic LBP.
治疗慢性下腰痛(LBP)的方法有很多,包括使用肌肉松弛剂和镇痛药。本文旨在比较乙哌立松和替扎尼定联合曲马多治疗慢性 LBP 的疗效和耐受性。
60 例慢性 LBP 伴脊柱旁肌肉挛缩患者随机分为两组:E 组(30 例)给予乙哌立松治疗;T 组(30 例)给予替扎尼定治疗。两组均给予曲马多控释片 100mg/d。在基线(T0)及治疗后 5 天(T5)、10 天(T10)、15 天(T15)和 30 天(T30)时,分别采用静息和用力时的视觉模拟评分(VAS)评估。计算总疼痛强度差(SPID)、SPID%(SPID%)和总疼痛缓解(TOTPAR),包括静息时(-r)和用力时(-e)。
两组治疗后 VAS-r 和 VAS-e 均显著降低,且在每个时间点均出现相似的降低。两组间 SPID-r 和 -e、SPID%-r 和 -e 以及 TOTPAR-r 和 -e 均相似。两组间嗜睡发生率有显著差异:E 组为 16.6%,T 组为 43.3%。E 组有 5 例和 T 组有 9 例因不良反应停止治疗,但无统计学差异。
两种联合治疗方案均能有效缓解慢性 LBP 的静息和用力时疼痛。乙哌立松/曲马多减少了停药率,使患者更能坚持治疗,可作为慢性 LBP 治疗的一种可行选择。