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度洛西汀与普瑞巴林对膝骨关节炎患者疼痛及相关因素影响的比较

Comparison of the effects of duloxetine and pregabalin on pain and associated factors in patients with knee osteoarthritis.

作者信息

Illeez Ozge Gulsum, Oktay Kubra Neslihan Kurt, Aktas Ilknur, Ozkan Feyza Unlu, Nazligül Tuba, Begoglu Feyza Akan, Kaysin Meryem Yilmaz, Atici Arzu, Akpinar Pinar

机构信息

University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey.

Yeditepe University Faculty of Medicine, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Mar;68(3):377-383. doi: 10.1590/1806-9282.20211047.

Abstract

OBJECTIVES

This study aimed to investigate the effects of duloxetine and pregabalin primarily on pain and functional status in patients with knee osteoarthritis and secondarily on quality of life, depression, anxiety, and sleep disturbance.

METHODS

A total of 66 patients with knee osteoarthritis were randomized to use duloxetine or pregabalin. Patients were evaluated by Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburg Sleep Quality Index before the treatment and after 4 and 12 weeks of treatment.

RESULTS

Improvements occurred in Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36 (with an exception of the mental health subgroup scores in duloxetine-treated group), Beck Depression Inventory, and Beck Anxiety Inventory scores in both groups from 4 weeks after baseline. Pittsburg Sleep Quality Index total scores and SF-36 mental health subgroup scores started to improve on the 4th and 12th weeks in pregabalin- and duloxetine-treated groups, respectively.

CONCLUSION

Osteoarthritis pain, a complex outcome with nociceptive and neuropathic components, leads to central sensitization in a chronic phase. Using centrally acting drugs in the control of pain and associated symptoms would increase the probability of treatment success.

摘要

目的

本研究旨在探讨度洛西汀和普瑞巴林主要对膝骨关节炎患者疼痛和功能状态的影响,其次对生活质量、抑郁、焦虑和睡眠障碍的影响。

方法

总共66例膝骨关节炎患者被随机分配使用度洛西汀或普瑞巴林。在治疗前以及治疗4周和12周后,通过视觉模拟量表、神经性疼痛诊断问卷、西安大略和麦克马斯特大学骨关节炎指数、简明健康状况调查问卷、贝克抑郁量表、贝克焦虑量表和匹兹堡睡眠质量指数对患者进行评估。

结果

从基线后4周起,两组患者的视觉模拟量表、神经性疼痛诊断问卷、西安大略和麦克马斯特大学骨关节炎指数、简明健康状况调查问卷(度洛西汀治疗组的心理健康亚组得分除外)、贝克抑郁量表和贝克焦虑量表得分均有所改善。匹兹堡睡眠质量指数总分以及简明健康状况调查问卷心理健康亚组得分分别在普瑞巴林治疗组和度洛西汀治疗组的第4周和第12周开始改善。

结论

骨关节炎疼痛是一种具有伤害性和神经性成分的复杂结果,在慢性期会导致中枢敏化。使用中枢作用药物控制疼痛及相关症状将增加治疗成功的可能性。

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