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不同醋氯芬酸治疗慢性下腰痛的疗效与安全性:前瞻性、随机、单中心、开放标签临床试验

Efficacy and Safety of Different Aceclofenac Treatments for Chronic Lower Back Pain: Prospective, Randomized, Single Center, Open-Label Clinical Trials.

作者信息

Yang Jae Ho, Suk Kyung Soo, Lee Byung Ho, Jung Woo Chul, Kang Young Mi, Kim Ji Hye, Kim Hak Sun, Lee Hwan Mo, Moon Seong Hwan

机构信息

Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Department of Orthopedic Surgery, Catholic-Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.

出版信息

Yonsei Med J. 2017 May;58(3):637-643. doi: 10.3349/ymj.2017.58.3.637.

Abstract

PURPOSE

Nonsteroidal anti-inflammatory drugs are a mainstay for medical treatment of chronic lower back pain (CLBP). Increased dose intervals for medication have been associated with increased patient adherence to prescriptions. The purpose of this clinical trial was to compare the efficacy and safety of a once daily dose of aceclofenac controlled release (CR) and a twice daily dose of aceclofenac for CLBP management.

MATERIALS AND METHODS

A prospective, randomized, single center, open-label clinical trial was performed to compare the efficacy and safety of aceclofenac CR (200 mg once daily) to aceclofenac dose (100 mg twice daily). Fifty patients in each group were enrolled for the study. The primary end point was Visual Analogue Scale (VAS) change at baseline to that at 2 weeks after medication and safety profiles. Also, change in quality of life measured by EuroQoL 5D (EQ-5D) and Oswestry Disability Index (ODI) functional score for the lumbar spine were also assessed.

RESULTS

Within groups at pre- and post-treatment, there were significant VAS reductions for aceclofenac CR and aceclofenac (p=0.028). EQ-5D increased significantly in both groups (p=0.037). ODI scores decreased significantly in both groups (p=0.012). However, there were no significant differences between aceclofenac CR and aceclofenac at pre- and post-treatment. Patients with aceclofenac CR showed significant increases in heartburn and indigestion and adverse gastrointestinal effects, compared to aceclofenac.

CONCLUSION

In patients with CLBP, aceclofenac CR and aceclofenac demonstrated significant symptomatic pain relief, improvement in quality of life and functional scores. Aceclofenac CR slightly increased gastrointestinal adverse effects, such as heartburn and indigestion.

摘要

目的

非甾体抗炎药是慢性下腰痛(CLBP)药物治疗的主要手段。延长用药间隔时间与患者对处方的依从性提高有关。本临床试验的目的是比较每日一次剂量的醋氯芬酸缓释片(CR)和每日两次剂量的醋氯芬酸治疗CLBP的疗效和安全性。

材料与方法

进行了一项前瞻性、随机、单中心、开放标签的临床试验,以比较醋氯芬酸CR(每日一次200mg)与醋氯芬酸普通剂型(每日两次100mg)的疗效和安全性。每组招募50名患者进行研究。主要终点是用药前至用药后2周的视觉模拟量表(VAS)变化以及安全性。此外,还评估了用欧洲五维健康量表(EQ-5D)测量的生活质量变化以及腰椎的Oswestry功能障碍指数(ODI)评分变化。

结果

在治疗前后的组内比较中,醋氯芬酸CR组和醋氯芬酸普通剂型组的VAS评分均显著降低(p = 0.028)。两组的EQ-5D均显著升高(p = 0.037)。两组的ODI评分均显著降低(p = 0.012)。然而,醋氯芬酸CR组和醋氯芬酸普通剂型组在治疗前后没有显著差异。与醋氯芬酸普通剂型组相比,醋氯芬酸CR组的烧心和消化不良以及胃肠道不良反应显著增加。

结论

在CLBP患者中,醋氯芬酸CR和醋氯芬酸均显示出显著的症状性疼痛缓解以及生活质量和功能评分的改善。醋氯芬酸CR略微增加了胃肠道不良反应,如烧心和消化不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5581/5368152/f45be6ba7f93/ymj-58-637-g001.jpg

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