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0.075%辣椒素洗剂治疗糖尿病性疼痛性神经病变:一项随机、双盲、交叉、安慰剂对照试验。

0.075% capsaicin lotion for the treatment of painful diabetic neuropathy: A randomized, double-blind, crossover, placebo-controlled trial.

作者信息

Kulkantrakorn Kongkiat, Chomjit Assawin, Sithinamsuwan Pasiri, Tharavanij Thipaporn, Suwankanoknark Juthamas, Napunnaphat Phunyada

机构信息

Division of Neurology, Department of Internal Medicine, Thammasat University, Pathumthani, Thailand; Center of Excellence for Diabetic Foot Care, Thammasat University Hospital, Pathumthani, Thailand.

Division of Neurology, Department of Internal Medicine, Thammasat University, Pathumthani, Thailand.

出版信息

J Clin Neurosci. 2019 Apr;62:174-179. doi: 10.1016/j.jocn.2018.11.036. Epub 2018 Nov 22.

Abstract

OBJECTIVE

A randomized, double-blinded, crossover, placebo controlled trial was conducted to evaluate the efficacy and safety of 0.075% capsaicin lotion for treating painful diabetic neuropathy (PDN).

PATIENTS AND METHODS

PDN subjects were randomized to receive 0.075% capsaicin/placebo for 8 weeks, then crossing over to the other treatment after a 4-weeks washout period. Primary endpoint was the change in visual analog scale score of pain severity. Secondary outcomes were score changes in Neuropathic Pain Scale, short-form McGill Pain Questionnaires, and proportions of patients with pain score reductions of 30% and 50%, and adverse events.

RESULTS

A total of 42 subjects were enrolled, 27 completed at least an 8-week treatment period. Intention-to-treat analysis showed no significant improvement in pain control with capsaicin lotion compared with placebo for all pain measures and proportion of patients who had 30% or 50% pain relief, respectively. Per protocol analysis were consistent. Capsaicin lotion was well tolerated but local skin reactions were common.

CONCLUSION

In patients with PDN, the efficacy of 0.075% capsaicin lotion was similar to placebo but was well tolerated. More work is needed to assess different capsaicin formulations.

摘要

目的

开展一项随机、双盲、交叉、安慰剂对照试验,以评估0.075%辣椒素洗剂治疗糖尿病性周围神经病变性疼痛(PDN)的疗效和安全性。

患者与方法

将PDN受试者随机分组,接受0.075%辣椒素/安慰剂治疗8周,然后在4周的洗脱期后交叉接受另一种治疗。主要终点是疼痛严重程度视觉模拟量表评分的变化。次要结局是神经病理性疼痛量表、简式麦吉尔疼痛问卷的评分变化,以及疼痛评分降低30%和50%的患者比例和不良事件。

结果

共纳入42名受试者,27名完成了至少8周的治疗期。意向性分析显示,与安慰剂相比,辣椒素洗剂在所有疼痛测量指标以及疼痛缓解30%或50%的患者比例方面,疼痛控制均无显著改善。符合方案分析结果一致。辣椒素洗剂耐受性良好,但局部皮肤反应常见。

结论

在PDN患者中,0.075%辣椒素洗剂的疗效与安慰剂相似,但耐受性良好。需要开展更多工作来评估不同的辣椒素制剂。

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