颈舒颗粒治疗神经根型颈椎病:首个多中心、随机、对照临床试验
Jingshu Keli for treating cervical spondylotic radiculopathy: The first multicenter, randomized, controlled clinical trial.
作者信息
Hu Jianhua, Chen Feng, Qiu Guixing, Sun Tiansheng, Yang Huilin, Shen Huiyong, Tong Peijian, Chai Yimin, Zhang Xueli, Zhang Weibin, Yang Zhidong, Jiang Hong, Pan Yalin, Zhu Tianliang, He Chengjian, Xiao Weiping
机构信息
Department of Orthopedics, Peking Union Medical College Hospital (PUMCH), Peking, China.
Department of Orthopedics, People's Liberation Army General Hospital, Peking, China.
出版信息
J Orthop Translat. 2020 Dec 21;27:44-56. doi: 10.1016/j.jot.2020.10.010. eCollection 2021 Mar.
BACKGROUND
Jingshu Keli (or Jingshu granules), a traditional Chinese medicine, are widely used for treating cervical spondylotic radiculopathy in China; however, no randomized, double-blind, controlled study has verified their effectiveness.
PURPOSE
To evaluate the efficacy and safety of Jingshu Keli for the treatment of cervical spondylotic radiculopathy in a randomized controlled trial.
DESIGN
From August 2015 to July 2017, a multicenter, randomized, double-blind, placebo-controlled trial was conducted at 13 large- and medium-sized hospitals in China.
PATIENT SAMPLE
A total of 360 and 120 patients were initially enrolled in the Jingshu and control groups, respectively; 386 patients completed the study, with 299 in the Jingshu group and 87 in the control group.
OUTCOME MEASURES
The main index for evaluating the curative effect was the pain score on a visual analogue scale (VAS; 0-100 points).
METHODS
All patients were administered a bag of Jingshu Keli or placebo 3 times a day for 4 weeks, and were interviewed at the second and fourth weeks. The decrease in pain scores and rate of change in pain scores after treatment were calculated, related laboratory indices were reviewed, and adverse reactions were recorded.
RESULTS
In the Per Protocol Set (PPS) analysis, the baseline pain VAS scores in the control and Jingshu groups were 49.31 ± 6.97 and 50.06 ± 7.33, respectively, with no significant difference between the groups (P > 0.05). While there were no differences at 2 weeks between groups, at four weeks the pain VAS scores in the control and Jingshu groups decreased by 12.86 ± 13.45 and 22.72 ± 15.08, respectively relative to the values at baseline, with significant group differences (P < 0.0001). While there were similar significant differences between the groups (P < 0.0001) in the Full Analysis Set (FAS) analyses neither group achieved the minimal clinically important difference at any time point.
CONCLUSIONS
Jingshu Keli are effective for the treatment of cervical spondylotic radiculopathy.
TRANSLATIONAL POTENTIAL STATEMENT
This is the first prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial that confirmed the clinical efficacy and safety of Jingshu Keli for treating cervical spondylotic radiculopathy, which can provide evidence for clinical treatment.
背景
颈舒颗粒,一种中药制剂,在中国广泛用于治疗神经根型颈椎病;然而,尚无随机、双盲、对照研究证实其有效性。
目的
通过一项随机对照试验评估颈舒颗粒治疗神经根型颈椎病的疗效和安全性。
设计
2015年8月至2017年7月,在中国13家大中型医院进行了一项多中心、随机、双盲、安慰剂对照试验。
患者样本
颈舒组和对照组最初分别纳入360例和120例患者;386例患者完成了研究,其中颈舒组299例,对照组87例。
观察指标
评估疗效的主要指标是视觉模拟量表(VAS;0 - 100分)上的疼痛评分。
方法
所有患者每天服用一袋颈舒颗粒或安慰剂,每日3次,共4周,并在第2周和第4周进行访视。计算治疗后疼痛评分的降低值和疼痛评分的变化率,复查相关实验室指标,并记录不良反应。
结果
在符合方案集(PPS)分析中,对照组和颈舒组的基线疼痛VAS评分分别为49.31 ± 6.97和50.06 ± 7.33,两组间无显著差异(P > 0.05)。两组在2周时无差异,但在4周时,对照组和颈舒组的疼痛VAS评分相对于基线值分别降低了12.86 ± 13.45和22.72 ± 15.08,组间差异显著(P < 0.0001)。在全分析集(FAS)分析中,两组间也存在类似的显著差异(P < 0.0001),但两组在任何时间点均未达到最小临床重要差异。
结论
颈舒颗粒对神经根型颈椎病有治疗作用。
转化潜力声明
这是第一项前瞻性、多中心、随机、双盲、安慰剂对照的临床试验,证实了颈舒颗粒治疗神经根型颈椎病的临床疗效和安全性,可为临床治疗提供依据。
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