Ghai Babita, Bansal Dipika, Kanukula Raju, Gudala Kapil, Sachdeva Naresh, Dhatt Saravdeep Singh, Kumar Vishal
Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh.
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar (Mohali).
Pain Physician. 2017 Jan-Feb;20(1):E99-E105.
Vitamin-D deficiency may possibly be related to chronic low back pain (CLBP).
The study is aimed to assess the impact of vitamin-D supplementation on pain intensity, functional disability, and vitamin-D levels in patients with CLBP.
Single arm open-label study.
Outpatient pain clinic of a tertiary care hospital.
Sixty-eight eligible patients (CLBP for = 3 months, pain score = 50 on visual analogue scale (VAS) and plasma 25-Hydroxyvitamin D3 levels < 30 ng/mL) were enrolled. Patients were supplemented with 60,000 IU of oral vitamin-D3 given every week for 8 weeks. Efficacy parameters included pain intensity and functional disability measured by VAS and modified Oswestry disability questionnaire (MODQ) scores at baseline, 2, 3, and 6 months post-supplementation. Plasma 25(OH) D3 levels were measured at baseline and 8 weeks.
Baseline mean (SD) vitamin-D levels were 12.8 (5.73) ng/mL and increased to 36.07 (12.51) post supplementation (P < 0.01). Forty-five (66%) patients attained normal levels (> 29 ng/mL) post supplementation. Significant reduction in VAS was observed at 2, 3, and 6 months [61 (19), 45 (19), 36 (18)] as compared to 81 (19) at baseline (P = 0.001 at all-time intervals). A significant improvement in the functional ability was also observed at 2, 3, and 6 months [36 (12), 31 (13), and 26 (10)] as compared to baseline 45 (16) (P = 0.001 at all-time intervals).
Vitamin-D supplementation in deficient CLBP patients may lead to improvement in pain intensity and functional ability apart from normalization of the levels. Future controlled clinical trials are required to confirm the hypothesis.Key words: Vitamin D, deficiency, screening, low back pain, chronic, supplementation.
维生素D缺乏可能与慢性下腰痛(CLBP)有关。
本研究旨在评估补充维生素D对CLBP患者疼痛强度、功能障碍及维生素D水平的影响。
单臂开放标签研究。
一家三级护理医院的门诊疼痛诊所。
纳入68例符合条件的患者(CLBP病程≥3个月,视觉模拟量表(VAS)疼痛评分≥50分且血浆25-羟基维生素D3水平<30 ng/mL)。患者每周口服60,000 IU维生素D3,共8周。疗效参数包括补充维生素D前、补充后2个月、3个月和6个月时通过VAS及改良奥斯威斯利功能障碍问卷(MODQ)评分测量的疼痛强度和功能障碍。在基线和8周时测量血浆25(OH)D3水平。
基线时维生素D水平的平均(标准差)值为12.8(5.73)ng/mL,补充后升至36.07(12.51)ng/mL(P<0.01)。45例(66%)患者补充后维生素D水平达到正常(>29 ng/mL)。与基线时的81(19)分相比,补充后2个月、3个月和6个月时VAS评分显著降低[分别为61(19)、45(19)、36(18)分](所有时间点P=0.001)。与基线时的45(16)分相比,补充后2个月、3个月和6个月时功能能力也显著改善[分别为36(12)、31(13)、26(10)分](所有时间点P=0.001)。
对维生素D缺乏的CLBP患者补充维生素D除了能使维生素D水平正常化外,还可能改善疼痛强度和功能能力。未来需要进行对照临床试验来证实这一假设。关键词:维生素D、缺乏、筛查、下腰痛、慢性、补充