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接种兔皮提取物能有效缓解慢性腰痛,且副作用极小——一项随机多中心双盲安慰剂对照3期临床试验。

, the extracts of -inoculated rabbit skin, effectively alleviates the chronic low back pain with little side effect - A randomized multi-center double-blind placebo-controlled phase 3 clinical trial.

作者信息

Dong Jian, Tu Hung-Ping, Ding Wen-Yuan, Ding Yue, Li Jin, Zhang Xue-Li, Fan Cun-Yi, Dong Hai-Long, Wu Yi-Chia, Wang Sebrina Su-Jung, Lin Chen-Lung Steve

机构信息

Department of Orthopedics, ZhongShan Hospital, Fudan University, Shanghai, China.

Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.

出版信息

Contemp Clin Trials Commun. 2015 Dec 19;2:16-24. doi: 10.1016/j.conctc.2015.11.002. eCollection 2016 Apr 15.

Abstract

BACKGROUND

Chronic low back pain affects daily activities at home and workplaces and causes a huge economic burden. Current therapeutic options are very limited and the effects of available pharmacological agents are less than satisfactory. While NSAIDs might be effective for the short term and opioids might help with urgent pain relief and improving the life quality, their long-term use is associated with significant side effects and drug misuse or abuse. To seek alternative pharmacological agents for effective treatment, we examined the therapeutic potential of the extracts of -inoculated rabbit skin ( abbreviated as ) in patients with chronic low back pain due to degenerative vertebral disorders.

METHODS

In this randomized multi-center double-blind placebo-controlled phase 3 clinical trial (Chinese Clinical Trial Registry number 2009L01498), we enrolled patients (aged 26-70 years) with chronic low back pain for at least 3 months due to degenerative spinal (vertebral) disorders from 7 medical centers in China, and randomly allocated 459 participants to receive oral or placebo for 28 days to study the efficacy and safety of . Randomization was performed according to a centralized randomization schedule, which was blocked by study sites and generated by an unmasked statistician independent of study conduct and data analysis. Both participants and staff at each study site were masked to treatment assignment. The primary efficacy endpoint was the change of the mean pain intensity, based on an 11-point numerical rating scale, between the baseline and the last week of treatment, with the primary efficacy analysis of intention to treat. The ratio between exposed and unexposed groups was designed to be 3:1 in order to increase the likelihood of demonstrating the effect upon repeated measures.

RESULTS

347 patients were assigned to receive (4 units/tablet; 2 tablets twice a day) and 112 patients were to take placebo. Among them, 324 patients taking and 112 receiving placebo completed the assessment. Patients receiving reported significant pain relief at the end of week 2 and 3 compared to those taking placebo, with mean reduction of the pain scores as 1.7 0.9 at week 2 (p < 0.0001) and 2.8 . 1.2 at week 3 (p < 0.0001). A total of 47 -treated patients reported 85 treatment emergent adverse events while 16 patients taking placebo reported 26 events, but no serious side effects were found to be related to treatment.

CONCLUSION

(, 8 units twice daily) effectively alleviates chronic low back pain due to degenerative vertebral disorders when compared to placebo and is well tolerated by tested individuals, and can be considered as a first-line treatment for chronic low pain due to degenerative vertebral diseases.

摘要

背景

慢性下腰痛影响家庭和工作场所的日常活动,并造成巨大的经济负担。目前的治疗选择非常有限,现有药物的效果不尽人意。虽然非甾体抗炎药可能在短期内有效,阿片类药物可能有助于紧急止痛和提高生活质量,但其长期使用会带来显著的副作用以及药物滥用问题。为寻求有效的替代药物,我们研究了接种兔皮肤提取物(简称为)对退行性椎体疾病所致慢性下腰痛患者的治疗潜力。

方法

在这项随机、多中心、双盲、安慰剂对照的3期临床试验(中国临床试验注册号2009L01498)中,我们纳入了来自中国7家医疗中心的26至70岁、因退行性脊柱(椎体)疾病导致慢性下腰痛至少3个月的患者,并将459名参与者随机分配接受口服或安慰剂治疗28天,以研究的疗效和安全性。随机分组按照集中随机方案进行,该方案由研究地点进行区组化,并由一名独立于研究实施和数据分析的非盲统计学家生成。每个研究地点的参与者和工作人员均对治疗分配情况不知情。主要疗效终点是基于11点数字评分量表,治疗基线与最后一周之间平均疼痛强度的变化,并进行意向性治疗的主要疗效分析。暴露组与非暴露组的比例设计为3:1,以便增加在重复测量时显示效果的可能性。

结果

347例患者被分配接受(4单位/片;每日2次,每次2片),112例患者服用安慰剂。其中,324例服用的患者和112例接受安慰剂的患者完成了评估。与服用安慰剂的患者相比,服用的患者在第2周和第3周结束时报告疼痛明显缓解,第2周时疼痛评分平均降低1.7±0.9(p<0.0001),第3周时降低2.8±1.2(p<0.0001)。共有47例接受治疗的患者报告了85例治疗中出现的不良事件,而16例服用安慰剂的患者报告了26例事件,但未发现严重副作用与治疗有关。

结论

与安慰剂相比,(每日2次,每次8单位)可有效缓解退行性椎体疾病所致的慢性下腰痛,且受试个体耐受性良好,可被视为退行性椎体疾病所致慢性下腰痛的一线治疗药物。

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