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一项安慰剂对照、受试者自身交叉试验的方案,该试验旨在评估鼻内注射催产素对改善慢性盆腔肌肉骨骼疼痛女性的疼痛和功能的疗效。

Protocol for a placebo-controlled, within-participants crossover trial evaluating the efficacy of intranasal oxytocin to improve pain and function among women with chronic pelvic musculoskeletal pain.

作者信息

Rash Joshua A, Toivonen Kirsti, Robert Magali, Nasr-Esfahani Maryam, Jarrell John F, Campbell Tavis S

机构信息

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

出版信息

BMJ Open. 2017 Apr 16;7(4):e014909. doi: 10.1136/bmjopen-2016-014909.

Abstract

INTRODUCTION

This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain. The association between oxytocin and pain may differ in women with chronic pelvic musculoskeletal pain relative to other chronic pain conditions because of the abundance of oxytocin receptors in the uterus.

METHODS AND ANALYSIS

This is a prospective, randomised, placebo-controlled, double-blind, within-participants crossover trial. 50 women with chronic pelvic musculoskeletal pain will be recruited through a local chronic pain centre and gynaecology clinics. Women will complete baseline measures and be randomised to an experimental or control condition that involve 2 weeks of self-administering twice-daily doses of 24 IU intranasal oxytocin or placebo, respectively. Women will then undergo a 2-week washout period before crossing over to receive the condition that they had not yet received. The primary outcome will be pain and function measured using the Brief Pain Inventory-Short Form. Secondary outcomes include emotional function, sleep disturbance and global impression of change. This trial will provide data on the 14-day safety and side-effect profile of intranasal oxytocin self-administered as an adjuvant treatment for chronic pelvic musculoskeletal pain.

ETHICS AND DISSEMINATION

This trial was granted approval from Health Canada and the University of Calgary Conjoint Health Research Ethics Board, and is registered online at ClinicalTrials.gov (#NCT02888574). Results will be disseminated to healthcare professionals through peer-reviewed publications and to the general public through press releases.

TRIAL REGISTRATION NUMBER

NCT02888574; Pre-results.

摘要

引言

本方案介绍了一项试验的基本原理和设计,该试验旨在评估鼻内注射催产素对改善慢性盆腔肌肉骨骼疼痛女性的疼痛和功能的疗效。催产素是一种神经肽,传统上被认为与分娩、生产和哺乳有关。新证据表明,催产素可降低人类的疼痛敏感性。虽然据报道,给予催产素可降低慢性背痛、头痛、便秘和结肠疼痛患者的疼痛敏感性,但尚无研究评估鼻内注射催产素与慢性盆腔肌肉骨骼疼痛之间的关联。由于子宫内催产素受体丰富,与其他慢性疼痛疾病相比,慢性盆腔肌肉骨骼疼痛女性中催产素与疼痛之间的关联可能有所不同。

方法与分析

这是一项前瞻性、随机、安慰剂对照、双盲、受试者内交叉试验。将通过当地慢性疼痛中心和妇科诊所招募50名慢性盆腔肌肉骨骼疼痛女性。女性将完成基线测量,并被随机分配到实验组或对照组,分别进行为期2周的每日两次自行鼻内注射24IU催产素或安慰剂。然后,女性将经历2周的洗脱期,之后交叉接受她们尚未接受的治疗。主要结局将采用简明疼痛量表简表测量疼痛和功能。次要结局包括情绪功能、睡眠障碍和总体变化印象。本试验将提供关于鼻内自行注射催产素作为慢性盆腔肌肉骨骼疼痛辅助治疗的14天安全性和副作用情况的数据。

伦理与传播

本试验已获得加拿大卫生部和卡尔加里大学联合健康研究伦理委员会的批准,并在ClinicalTrials.gov(#NCT02888574)上进行了在线注册。研究结果将通过同行评审出版物传播给医疗专业人员,并通过新闻稿向公众发布。

试验注册号

NCT02888574;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92a0/5775465/0053bfa2c2a0/bmjopen-2016-014909f01.jpg

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