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褪黑素治疗灼口综合征患者的疗效:一项三盲、安慰剂对照、交叉随机临床试验。

Melatonin Treatment in Patients with Burning Mouth Syndrome: A Triple-Blind, Placebo-Controlled, Crossover Randomized Clinical Trial.

出版信息

J Oral Facial Pain Headache. 2018;32(2):178-188. doi: 10.11607/ofph.1913.

Abstract

AIMS

To evaluate the efficacy of melatonin compared to placebo in reducing pain associated with burning mouth syndrome (BMS), as well as side effects of treatment and effects on sleep quality, anxiety, and serum and salivary melatonin levels.

METHODS

In this triple-blind, randomized clinical trial, 20 BMS patients (mean age ± standard deviation: 64.4 ± 11.5 years; range: 35 to 82 years) were enrolled to receive melatonin (12 mg/day) or placebo for 8 weeks in a crossover design. After treatment, changes in pain from baseline were ascertained by patient self-assessment with a verbal category scale and a visual analog scale. Secondary outcomes included evaluation of changes in sleep quality and anxiety. Data were subjected to analysis of variance (ANOVA), Fisher exact test, paired t test, Wilcoxon signed rank test, or chi-square test, as appropriate.

RESULTS

Melatonin was not superior to placebo in reducing pain. Melatonin significantly improved anxiety scores, though without strong clinical relevance. Independent of treatment, sleep quality did not significantly change during the trial, although melatonin slightly increased the number of hours slept. After active treatment, the mean ± standard error serum melatonin level peaked at 1,520 ± 646 pg/mL. A generally safe pharmacologic profile of melatonin was observed, and the placebo and melatonin treatments resulted in similar adverse effects.

CONCLUSION

Within the limitations of this study, melatonin did not exhibit higher efficacy than placebo in relieving pain in BMS patients.

摘要

目的

评估褪黑素相较于安慰剂在减轻灼口综合征(BMS)相关疼痛方面的疗效,以及治疗的副作用和对睡眠质量、焦虑、血清和唾液褪黑素水平的影响。

方法

在这项三盲、随机临床试验中,20 名 BMS 患者(平均年龄±标准差:64.4±11.5 岁;范围:35 至 82 岁)被纳入研究,以交叉设计接受褪黑素(12 毫克/天)或安慰剂治疗 8 周。治疗后,通过患者的口头类别量表和视觉模拟量表自评来确定疼痛相对于基线的变化。次要结局包括评估睡眠质量和焦虑的变化。数据采用方差分析(ANOVA)、Fisher 确切检验、配对 t 检验、Wilcoxon 符号秩检验或卡方检验进行分析,具体取决于数据类型。

结果

褪黑素在减轻疼痛方面并不优于安慰剂。褪黑素虽显著改善了焦虑评分,但临床相关性不强。独立于治疗,试验期间睡眠质量没有显著变化,尽管褪黑素略微增加了睡眠时间。在积极治疗后,平均±标准误血清褪黑素水平峰值为 1520±646pg/ml。褪黑素具有相对安全的药理学特征,且安慰剂和褪黑素治疗导致的不良反应相似。

结论

在本研究的限制范围内,褪黑素在缓解 BMS 患者疼痛方面并未显示出比安慰剂更高的疗效。

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