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桂枝加术附汤(TJ-18)治疗退行性膝关节骨关节炎患者:一项多中心随机安慰剂对照双盲临床试验的经验与有效应答者

Gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo-Controlled Double-Blind Clinical Trial.

作者信息

Kim Myung Kwan, Leem Jungtae, Kim Young Il, Kim Eunseok, Park Yang Chun, Sul Jae-Uk, Jo Hee-Geun, Yoon Sang-Hoon, Kim Jeeyong, Jeon Ju-Hyun, Jung In Chul

机构信息

Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea.

Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju 61949, Republic of Korea.

出版信息

Evid Based Complement Alternat Med. 2020 Oct 28;2020:2376581. doi: 10.1155/2020/2376581. eCollection 2020.

DOI:10.1155/2020/2376581
PMID:33178309
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7647757/
Abstract

BACKGROUND

Gyejigachulbutang (GUI-ZHI-JIA-SHU-FU-TANG, GCB) is an herbal formula widely prescribed in traditional East Asian medicine practice for arthritis and muscle pain. We evaluated the efficacy and safety of GCB for degenerative knee osteoarthritis (KOA).

METHODS

Eighty patients with KOA were randomly assigned to the GCB group or the placebo group in a 1 : 1 ratio in two Korean medicine hospitals. Patients took GCB or placebo three times a day for 4 weeks. Primary outcome was the change in the visual analogue scale (VAS) score for knee pain from baseline to 4 week. Secondary outcomes were the change in the VAS score from baseline to 2 week and 8 week, Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), European Quality of Life Five Dimensions questionnaire (EQ-5D), and safety.

RESULTS

There was no significant difference between the compared indicators of the GCB and placebo groups. However, in subgroup analysis, GCB was effective for subjects with a BMI lower than 25 kg/m. The dose of pain medication was significantly lower in the GCB group than in the placebo group after four weeks (=0.016). There were no serious adverse events in the GCB group.

CONCLUSIONS

GCB was not effective in primary outcome analysis. In exploratory subgroup analysis, GCB might be effective for individuals with BMI lower than 25 kg/m for the treatment of degenerative KOA. GCB may also help reduce the consumption of pain medication. Furthermore, research is required for our hypothesis. This trial is registered with KCT0003024.

摘要

背景

桂枝加术附汤(Gyejigachulbutang,GCB)是一种在东亚传统医学实践中广泛用于治疗关节炎和肌肉疼痛的草药配方。我们评估了GCB治疗退行性膝关节骨关节炎(KOA)的疗效和安全性。

方法

在两家韩医院,80例KOA患者按1∶1比例随机分为GCB组或安慰剂组。患者每天服用GCB或安慰剂3次,共4周。主要结局是从基线到4周时膝关节疼痛视觉模拟量表(VAS)评分的变化。次要结局是从基线到2周和8周时VAS评分的变化、韩国西安大略和麦克马斯特大学骨关节炎指数(K-WOMAC)、欧洲生活质量五维度问卷(EQ-5D)以及安全性。

结果

GCB组和安慰剂组的比较指标之间无显著差异。然而,在亚组分析中,GCB对体重指数(BMI)低于25kg/m²的受试者有效。四周后,GCB组的止痛药物剂量显著低于安慰剂组(P=0.016)。GCB组未发生严重不良事件。

结论

在主要结局分析中,GCB无效。在探索性亚组分析中,GCB可能对BMI低于25kg/m²的个体治疗退行性KOA有效。GCB还可能有助于减少止痛药物的使用。此外,我们的假设还需要进一步研究。本试验已在KCT0003024注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2a8/7647757/95426c412793/ECAM2020-2376581.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2a8/7647757/95426c412793/ECAM2020-2376581.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2a8/7647757/95426c412793/ECAM2020-2376581.001.jpg

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