Gaffey Andrew, Slater Helen, Porritt Kylie, Campbell Jared M
1The Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia 2School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
JBI Database System Rev Implement Rep. 2017 Feb;15(2):486-516. doi: 10.11124/JBISRIR-2016-003266.
Western countries are increasingly using complementary and alternative medicine (CAM) to assist with relieving ailments. Turmeric, from the ginger family Zingiberaceae, has a history of use for medicinal purposes. The polyphenols found in turmeric (curcuminoids) have demonstrated anti-inflammatory and pain relieving properties. With the use of CAMs increasing, it is important for the effectiveness of curcuminoids to be established.
To identify the effectiveness of the use of curcuminoids for the amelioration of musculoskeletal pain.
Persons experiencing musculoskeletal pain, including experimentally induced musculoskeletal pain.
TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: The current review considered studies that evaluated the use of curcuminoids.
Any form including placebo, treatment as usual or before and after measurements.
Both experimental and epidemiological study designs including randomized controlled trials (RCTs), non-RCTs, quasi-experimental and before and after studies were eligible for consideration in this review. Studies published in English were considered without date restriction.
The current review considered studies that included measurement of pain. Outcome measures included visual analog scales, and/or pain questionnaires. Secondary outcome measures of functionality (activities of daily living and range of motion) were included. Any data provided on adverse events were considered.
The databases PubMed, CINAHL, Embase and ProQuest were searched in March 2015 (and updated in April 2016) using the Joanna Briggs Institute (JBI) three-step search strategy. The reference lists of identified articles were reviewed for additional studies.
Papers selected were assessed by two independent reviewers using standardized instruments from the JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).
Data were extracted using the data extraction tool from JBI-MAStARI. Data extracted included details about the populations, interventions, study methods and outcomes.
Narrative and tabular synthesis was conducted. Meta-analysis was precluded due to methodological and clinical heterogeneity across all included studies.
Thirteen studies with a combined total of 1101 participants were included. Three studies of limited sample size examined the effects of curcuminoids compared with the use of placebo on musculoskeletal pain, with one study showing a statistically significant effect. Four studies examined the effects of curcuminoids compared with non-selective non-steroidal anti-inflammatory drugs on musculoskeletal pain. Two of these four studies were non-inferiority studies showed that the use of both curcuminoids and ibuprofen were associated with a similar significant reduction in pain over the study durations of four and six weeks, respectively, with curcuminoid use non-inferior to the use of ibuprofen over the study durations. Six studies investigated presentations of curcuminoid-containing herbomineral mixtures versus placebo or active controls.
There is insufficient evidence to recommend that curcuminoids be considered for relieving pain and improving function in musculoskeletal pain conditions. This finding needs to be considered in the context of limitations imposed by the variability in the quality of studies, small sample sizes, short duration of interventions, a gender-bias toward females, absence of long-term data extraction and small number of relevant studies.
西方国家越来越多地使用补充和替代医学（CAM）来辅助缓解疾病。姜科姜属的姜黄有着药用历史。姜黄中发现的多酚类物质（姜黄素类化合物）已显示出抗炎和止痛特性。随着补充和替代医学使用的增加，确定姜黄素类化合物的有效性很重要。
确定使用姜黄素类化合物改善肌肉骨骼疼痛的有效性。
纳入标准 参与者类型：经历肌肉骨骼疼痛的人，包括实验诱导的肌肉骨骼疼痛。
干预类型/感兴趣的现象：本综述考虑了评估姜黄素类化合物使用情况的研究。
任何形式，包括安慰剂、常规治疗或前后测量。
实验性和流行病学研究设计，包括随机对照试验（RCT）、非RCT、准实验以及前后研究，均符合本综述的考虑条件。以英文发表的研究无日期限制。
本综述考虑了包括疼痛测量的研究。结局指标包括视觉模拟量表和/或疼痛问卷。纳入了功能（日常生活活动和活动范围）的次要结局指标。考虑了提供的任何不良事件数据。
2015年3月检索了数据库PubMed、CINAHL、Embase和ProQuest（2016年4月更新），使用乔安娜·布里格斯研究所（JBI）的三步检索策略。对已识别文章的参考文献列表进行审查以查找其他研究。
由两名独立评审员使用JBI统计评估与综述工具（JBI-MAStARI）中的标准化工具对所选论文进行评估。
使用JBI-MAStARI的数据提取工具提取数据。提取的数据包括有关人群、干预措施、研究方法和结局的详细信息。
进行了叙述性和表格性综合。由于所有纳入研究在方法学和临床方面存在异质性，因此未进行荟萃分析。
纳入了13项研究，共计1101名参与者。三项样本量有限的研究考察了姜黄素类化合物与安慰剂相比对肌肉骨骼疼痛的影响，其中一项研究显示有统计学显著效果。四项研究考察了姜黄素类化合物与非选择性非甾体抗炎药相比对肌肉骨骼疼痛的影响。这四项研究中的两项为非劣效性研究，表明在分别为期四周和六周的研究期间，使用姜黄素类化合物和布洛芬均与疼痛显著减轻相似，在研究期间使用姜黄素类化合物不劣于使用布洛芬。六项研究调查了含姜黄素类化合物的草药矿物质混合物与安慰剂或活性对照的表现。
没有足够的证据推荐将姜黄素类化合物用于缓解肌肉骨骼疼痛状况中的疼痛和改善功能。这一发现需要在研究质量差异、样本量小、干预持续时间短、对女性的性别偏见、缺乏长期数据提取以及相关研究数量少等限制背景下加以考虑。
