Department of Emergency Medicine, Alanya State Hospital, Antalya, Turkey.
Department of Emergency Medicine, Pamukkale University, Medical Faculty, Denizli, Turkey.
Med Sci Monit. 2019 Jan 6;25:157-164. doi: 10.12659/MSM.911711.
BACKGROUND NSAIDs are the most common agents used in dysmenorrhea treatment. They reduce menstrual pain by reducing uterine pressure and PGF2alpha levels in the menstrual fluid. The aim of this study was to compare the effects of piroxicam and diclofenac sodium as treatments for primary dysmenorrhea. MATERIAL AND METHODS The study was conducted using a randomized and double-blind method. Patients with Visual Analogue Scale (VAS) scores greater than 5 were accepted into the study. The patients who were suitable for inclusion were randomized into 2 groups and received either intramuscular piroxicam or diclofenac sodium. The patients' pain levels were measured at baseline and at 15, 30, 45, and 60 min. A VAS of 10 cm, a numeric scale, a verbal scale, and additional symptoms, as well as pain relapse after 24 hours and required analgesics, were recorded. RESULTS The study included 400 patients. Overall, 200 patients (50%) were in the proxicam group, and 200 patients were in the diclofenac sodium group. The average decrease on the VAS after piroxicam or diclofenac administration was measured as 7.9±1.8 cm and 7.9±1.7 cm (median ± standard deviation), respectively. The pain-reducing efficiency of all the treatments was compared using the Mann-Whitney U test (p=0.929). Rescue medication was needed for 25 patients in the proxicam group (p=0.014). Overall, 30 patients in the proxicam group and 41 patients in the proxicam group needed analgesics again in the 24-hour period after treatment (p=0.150). CONCLUSIONS At the end of our study, it was observed that there was no difference in the results of primary dysmenorrhea treatment with 20 mg piroxicam or 75 mg diclofenac sodium.
非甾体抗炎药(NSAIDs)是治疗痛经最常用的药物。它们通过降低子宫压力和月经液中的 PGF2alpha 水平来减轻月经疼痛。本研究旨在比较吡罗昔康和双氯芬酸钠钠作为原发性痛经治疗的效果。
本研究采用随机双盲法进行。接受视觉模拟评分(VAS)大于 5 分的患者被纳入研究。适合纳入的患者随机分为 2 组,分别接受肌肉注射吡罗昔康或双氯芬酸钠钠。在基线和 15、30、45 和 60 分钟测量患者的疼痛程度。记录 10 cm VAS、数字评分、口头评分以及其他症状,以及 24 小时后疼痛复发和需要使用镇痛药的情况。
该研究共纳入 400 名患者。总体而言,200 名患者(50%)在吡罗昔康组,200 名患者在双氯芬酸钠钠组。吡罗昔康或双氯芬酸钠给药后 VAS 的平均下降值分别为 7.9±1.8 cm 和 7.9±1.7 cm(中位数±标准差)。使用 Mann-Whitney U 检验比较所有治疗方法的止痛效果(p=0.929)。吡罗昔康组需要解救药物的患者有 25 例(p=0.014)。总体而言,治疗后 24 小时内,吡罗昔康组有 30 例和 41 例患者需要再次使用镇痛药(p=0.150)。
在我们的研究结束时,观察到 20mg 吡罗昔康或 75mg 双氯芬酸钠钠治疗原发性痛经的结果没有差异。