TAMMEF Centre, University of Siena, Siena, Italy -
Eur J Phys Rehabil Med. 2013 Oct;49(5):659-64. Epub 2013 Jul 9.
Neuropathic mechanisms largely contribute to low back pain (LBP) and oxidative stress is acknowledged as one of the causes of nerve damage typical of neuropathic pain: antioxidant agents may be a useful choice in the multimodal treatment strategy for chronic LBP patients.
The aim of this study was to detect changes in perceived pain, functional activity and in the assumption of analgesics in patients with chronic LBP treated with a combination of alpha-lipoic acid (ALA) and superoxide dismutase (SOD).
Prospective non-randomized open-label study.
Outpatient at TAMMEF (Therapeutic Application of Musically Modulated Electromagnetic Fields) Centre of the University of Siena.
The study enrolled 98 adult patients with chronic (≥12 weeks) LBP with or without radiculopathy and without neoplastic or inflammatory pathologies.
Patients were treated for 60 days with 600 mg ALA and 140 UI SOD/die. The Roland Morris Disability Questionnaire and Pain Rating Scale were used and concomitant use of medications (with particular attention to analgesics) and adverse events (toxicity) were recorded during treatment. Differences between all the study time points were calculated for the scores of the two tools and for the need of concomitant treatment with analgesics.
At the end of the study only 8% of patients still used analgesics versus 73.5% registered at baseline (P<0.01). Regarding self-reported tools, a statistically significant improvement both for perceived pain and functional disabilities occurred: pain ameliorated after 40 days of therapy and the improvement was significant both statistically (P<0.05) and clinically. Only 4 patients stopped the treatment due to unacceptable pain (not related to the treatment).
Oral treatment with ALA and SOD improves functionality and reduces the use of analgesics in chronic LBP patients.
Oral combination of ALA and SOD may be a powerful adjuvant in multimodal therapy of chronic LBP patients.
神经病理性机制在很大程度上导致了腰痛（LBP），氧化应激被认为是神经损伤的原因之一，这种损伤是神经病理性疼痛的典型特征：抗氧化剂可能是慢性 LBP 患者多模式治疗策略中的一个有用选择。
本研究旨在检测慢性 LBP 患者接受α-硫辛酸（ALA）和超氧化物歧化酶（SOD）联合治疗后，疼痛感知、功能活动和镇痛药物使用的变化。
前瞻性非随机开放标签研究。
锡耶纳大学 TAMMEF（音乐调制电磁场治疗应用）中心的门诊。
本研究纳入了 98 名患有慢性（≥12 周）LBP 伴或不伴神经根病且无肿瘤或炎症性病变的成年患者。
患者接受 60 天的 600mg ALA 和 140UI SOD/die 治疗。使用 Roland Morris 残疾问卷和疼痛评分量表，并记录治疗期间同时使用的药物（特别注意镇痛药）和不良事件（毒性）。计算两种工具的评分以及同时使用镇痛药的需求在所有研究时间点之间的差异。
研究结束时，只有 8%的患者仍在使用镇痛药，而基线时为 73.5%（P<0.01）。关于自我报告的工具，疼痛感知和功能障碍都有统计学上显著的改善：治疗 40 天后疼痛减轻，且在统计学上（P<0.05）和临床上都有显著改善。只有 4 名患者因无法忍受的疼痛（与治疗无关）而停止治疗。
口服 ALA 和 SOD 治疗可改善慢性 LBP 患者的功能并减少镇痛药的使用。
ALA 和 SOD 的口服联合治疗可能是慢性 LBP 患者多模式治疗的有力辅助手段。
