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两种非甾体抗炎药作为辅助药物治疗慢性颞下颌关节紊乱病的镇痛效果评估

Analgesia evaluation of 2 NSAID drugs as adjuvant in management of chronic temporomandibular disorders.

作者信息

Kurita Varoli Fernando, Sucena Pita Murillo, Sato Sandra, Issa João Paulo Mardegan, do Nascimento Cássio, Pedrazzi Vinícius

机构信息

Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café s/no, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil.

Department of Morphology, Physiology, and Basic Pathology, Avenida do Café s/no, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil.

出版信息

ScientificWorldJournal. 2015;2015:359152. doi: 10.1155/2015/359152. Epub 2015 Mar 22.

Abstract

The aim of this triple-blind full-randomized clinical trial was to quantify analgesia in masticatory muscles and temporomandibular joints after occlusal splint therapy associated with the adjuvant administration of nonsteroidal anti-inflammatory drugs (NSAID) isolated or associated with other therapeutic agents. Pain relief was also recorded. Eighteen volunteers who had been suffering from chronic pain in masticatory muscles due to temporomandibular disorders were selected after anamnesis and assessment using RDC/TMD translated to Portuguese. The 3 proposed treatments were NSAID (sodium diclofenac), panacea (sodium diclofenac + carisoprodol + acetaminophen + caffeine), and a placebo. The total treatment duration was 10 days, preceded and succeeded by patients' pain assessment. A washout interval of 11 days was established between each therapy. All participants received all treatments in different moments, in a full randomized crossover methodology. The assessment of drug therapies was performed using visual analogue scale for pain on palpation followed by 11-point numerical scale to quantify pain during treatment. Statistical analysis has shown that, after 10 days of treatment, all therapies were effective for pain relief. NSAID therapy promoted analgesia on the third day, while placebo only promoted analgesia in the eighth day. It has been concluded that sodium diclofenac used as splint adjuvant therapy, promotes significant analgesia in a shorter time.

摘要

这项三盲完全随机临床试验的目的是,量化在咬合板治疗联合单独使用或联合其他治疗药物辅助给予非甾体抗炎药(NSAID)后咀嚼肌和颞下颌关节的镇痛效果。同时记录疼痛缓解情况。在进行问诊并使用翻译成葡萄牙语的RDC/TMD进行评估后,选择了18名因颞下颌关节紊乱而患有咀嚼肌慢性疼痛的志愿者。三种拟定的治疗方法分别是NSAID(双氯芬酸钠)、万灵药(双氯芬酸钠+卡立普多+对乙酰氨基酚+咖啡因)和安慰剂。总治疗时长为10天,在治疗前后对患者进行疼痛评估。每种治疗之间设定11天的洗脱期。所有参与者均采用完全随机交叉法在不同时间接受所有治疗。使用视觉模拟评分法评估触诊时的疼痛,随后用11点数字评分法量化治疗期间的疼痛,以此对药物治疗进行评估。统计分析表明,治疗10天后,所有治疗方法均能有效缓解疼痛。NSAID治疗在第三天产生镇痛效果,而安慰剂仅在第八天产生镇痛效果。得出的结论是,双氯芬酸钠用作夹板辅助治疗,能在更短时间内产生显著的镇痛效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6fb/4385689/aaa90faa423e/TSWJ2015-359152.001.jpg

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