Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy,
Int J Biometeorol. 2014 Jan;58(1):79-86. doi: 10.1007/s00484-012-0627-6. Epub 2013 Jan 14.
The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. Primary outcome measures were global spontaneous hand pain on a visual analogue scale (VAS) and the functional index for hand osteoarthritis (FIHOA) score; secondary outcomes were health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OA last over time.
本研究旨在评估矿泉浴疗法对原发性手骨关节炎（OA）患者的短期和长期疗效。这是一项前瞻性随机、单盲对照试验。共纳入 60 例双侧原发性手 OA 门诊患者，随机分为两组。一组（n=30）接受 12 天局部泥敷和全身性热浴，外加硫酸盐-钙-镁-氟化物矿泉水；对照组（n=30）继续常规门诊治疗（运动、非甾体抗炎药和/或镇痛药）。每位患者在基线、治疗后 2 周、3、6、9 和 12 个月时接受检查。主要疗效指标为视觉模拟量表（VAS）的手部自发疼痛总体评分和手部骨关节炎功能指数（FIHOA）评分；次要疗效指标为健康评估问卷（HAQ）、晨僵持续时间、医疗结局研究 36 项简明健康调查量表（SF-36）和症状性药物使用情况。我们的结果表明，矿泉浴疗法在所有评估参数上均有效，治疗结束时和治疗后 3 个月时均有效；FIHOA、HAQ 和药物使用的评分在 6 个月时仍明显优于基线水平。对照组在整个随访过程中，各项参数均无明显变化。两组在第 15 天和 3 个月随访时，所有参数的差异均有统计学意义；FIHOA、HAQ 和症状性药物使用的差异在 6 个月随访时仍持续存在且具有统计学意义。矿泉浴疗法的耐受性似乎良好。总之，我们的结果证实，矿泉浴疗法对手部 OA 患者的有益作用可持续一段时间。
