Dehghan Morteza
Department of Orthopedic Surgery, Shahrekord University of Medical Science, Shahrekord, Iran.
Med Arch. 2015 Apr;69(2):103-6. doi: 10.5455/medarh.2015.69.103-106. Epub 2015 Apr 6.
Knee osteoarthritis is one of the most prevalent chronic disorders. Several pharmacological and non pharmacological approaches are used to treat this disease. Today, the effect of B and E vitamins on rheumatology diseases is being discussed. In this study, the efficacy of B and E vitamins accompanied with diclofenac on pain relief in patients with knee osteoarthritis was investigated and compared.
In this double-blinded clinical trial, 120 patients with knee osteoarthritis referring training Rheumatology and Orthopedics Clinic of Shahrekord University of Medical sciences were investigated. Of these patients, 12 were excluded throughout the study. The patients underwent treatment in three groups (oral diclofenac + oral B vitamin, oral diclofenac + oral vitamin E, and oral diclofenac + placebo). Pain relief was assessed by visual analogue scale (VAS) questionnaire and morning stiffness and physical function were assessed by WOMAC standard questionnaire at three times; the first examination, two weeks, and three weeks after referring.
The mean score of WOMAC questionnaire at VASs of knee pain, total pain severity, knee joint stiffness, and function of the last 48 hours decreased significantly in all three groups (diclofenac, E and B vitamins) from the first to third examination (P<0.001). Decrease in VAS of knee pain and function of the last 48 hours was higher in B vitamin group than the diclofenac and E vitamin group (P=0.008) and decrease in total pain severity was reported higher in B vitamin group than E vitamin and diclofenac group (P=0.019). Decrease in knee joint stiffness underwent a similar trend in the three groups.
In view similar analgesic and anti-inflammatory properties, as well as very few, non prevalent complications of B and E vitamins, use of two or more drugs with a different mechanism of effect seems necessary to enhance their effect on osteoarthritis treatment.
膝关节骨关节炎是最常见的慢性疾病之一。有多种药物和非药物方法用于治疗该疾病。如今，维生素B和E对风湿性疾病的作用正在被探讨。在本研究中，对维生素B和E联合双氯芬酸缓解膝关节骨关节炎患者疼痛的疗效进行了调查和比较。
在这项双盲临床试验中，对120名前往设拉子医科大学风湿病与骨科临床培训中心就诊的膝关节骨关节炎患者进行了调查。在整个研究过程中，其中12名患者被排除。患者被分为三组接受治疗（口服双氯芬酸 + 口服维生素B、口服双氯芬酸 + 口服维生素E、口服双氯芬酸 + 安慰剂）。通过视觉模拟量表（VAS）问卷评估疼痛缓解情况，并在三次时间点使用WOMAC标准问卷评估晨僵和身体功能；首次检查时、就诊后两周和三周。
在所有三组（双氯芬酸、维生素E和维生素B）中，从首次检查到第三次检查，膝关节疼痛的VAS评分、总疼痛严重程度、膝关节僵硬程度以及过去48小时的功能方面，WOMAC问卷的平均分均显著下降（P<0.001）。维生素B组膝关节疼痛的VAS评分和过去48小时的功能下降幅度高于双氯芬酸组和维生素E组（P=0.008），维生素B组总疼痛严重程度的下降幅度高于维生素E组和双氯芬酸组（P=0.019）。三组膝关节僵硬程度的下降趋势相似。
鉴于维生素B和E具有相似的镇痛和抗炎特性，以及极少且不常见的并发症，使用两种或更多种作用机制不同的药物似乎有必要，以增强它们对骨关节炎治疗的效果。
