Danilov A B, Devlikamova F I, Kurushina O V, Karakulova Yu V, Butko D Yu, Smirnova A A
Sechenov First Moscow State Medical University, Moscow, Russia.
Kazan State Medical Academy - branch of Russian medical Academy of continuing professional education, Kazan, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4):97-107. doi: 10.17116/jnevro202412404197.
Evaluation of the effect of Neuromidine on the dynamics of pain syndrome in the treatment of patients with discogenic lumbosacral radiculopathy.
Patients with a confirmed diagnosis of discogenic lumbosacral radiculopathy no more than one year old and moderate intensity of pain syndrome on a visual analog scale were included in the main group (OH, =62, age - 53.1±15.6 yrs) and the comparison group (HS, =40, age - 53.7±12.9 yrs). OG patients received Neuromidine (15 mg/1 mL 1 once a day IM for 10 days, then 20 mg 3 times a day for 8 weeks) in addition to the standard drug therapy, HS patients received only standard drug therapy. The duration of the study was 8 weeks. The degree of decrease in the intensity and dynamics of pain syndrome, activity and frequency of pain in the lumbar spine, changes in the level of physical activity, and the severity of emotional disorders were evaluated. The level of inflammatory markers in the blood and the dynamics of monosynaptic spinal H-reflex parameters were evaluated.
Before the study, there were no statistically significant differences there were no results of clinical and laboratory-instrumental examination between groups. After 8 weeks, the reduction of pain by VAS in the main group was statistically significant in contrast to the comparison group (=0.0001). In the main group there was a statistically significant increase in the mean cognitive impairment score (=0.0029), as well as an improvement in psycho-emotional state with a significant decrease in GAD-7 (=0.0002) and PHQ-9 (=0.0096). After 8 weeks of therapy, IL-6 level in the main group was statistically significantly lower (=0.0027) than in the comparison group. The results of H-reflex study revealed an increase in its amplitude and some shortening of latency at the end of Neuromidine therapy. The drug had no undesirable side effects and was well tolerated.
Administration of Neuromidine 15 mg/1 ml once a day intramuscularly for 10 days followed by 20 mg 3 times a day for 8 weeks has an effective analgesic effect as adjuvant therapy in patients with discogenic lumbosacral radiculopathy. The inclusion of Neuromidine in the complex treatment of patients with pain syndrome in discogenic radiculopathy is superior in efficacy to standard drug therapy.
评估Neuroidine对椎间盘源性腰骶神经根病患者疼痛综合征动态变化的影响。
确诊为不超过1年的椎间盘源性腰骶神经根病且视觉模拟量表疼痛综合征强度为中度的患者被纳入主要组(OH,n = 62,年龄 - 53.1±15.6岁)和对照组(HS,n = 40,年龄 - 53.7±12.9岁)。OH组患者除接受标准药物治疗外,还接受Neuroidine(15mg/1mL,每日1次肌肉注射,共10天,然后20mg,每日3次,共8周)治疗,HS组患者仅接受标准药物治疗。研究持续时间为8周。评估疼痛综合征强度和动态变化的减轻程度、腰椎疼痛的活动度和频率、身体活动水平的变化以及情绪障碍的严重程度。评估血液中炎症标志物水平和单突触脊髓H反射参数的动态变化。
研究前,两组间临床和实验室 - 仪器检查结果无统计学显著差异。8周后,主要组VAS疼痛减轻程度与对照组相比有统计学显著差异(P = 0.0001)。主要组平均认知障碍评分有统计学显著升高(P = 0.0029),心理 - 情绪状态改善,GAD - 7(P = 0.0002)和PHQ - 9(P = 0.0096)显著降低。治疗8周后,主要组IL - 6水平统计学显著低于对照组(P = 0.0027)。H反射研究结果显示,Neuroidine治疗结束时其波幅增加且潜伏期有所缩短。该药物无不良副作用且耐受性良好。
对于椎间盘源性腰骶神经根病患者,每日1次肌肉注射15mg/1ml的Neuroidine共10天,然后每日3次20mg共8周,作为辅助治疗具有有效的镇痛作用。在椎间盘源性神经根病疼痛综合征患者的综合治疗中加入Neuroidine在疗效上优于标准药物治疗。