Rheumatology Department, Siena University Hospital, Viale Mario Bracci 16, 53100 Siena, Italy.
Nutrients. 2024 Aug 21;16(16):2785. doi: 10.3390/nu16162785.
Fibromyalgia is characterized by chronic widespread pain, fatigue, and sleep disturbances. Recent theories attribute fibromyalgia to central sensitization syndromes, suggesting altered nociceptive processing leads to hyperalgesia and allodynia. Standardized effective treatments are currently lacking. Palmitoylethanolamide and melatonin have shown pain-relieving effects in chronic pain conditions, including fibromyalgia, with excellent safety. Our open-label study assessed the impact of a daily combination of 1200 mg of palmitoylethanolamide and 0.2 mg of melatonin on pain, sleep, and quality of life in fibromyalgia patients. Between June 2023 and March 2024, 50 patients (2016 ACR criteria) were treated and evaluated at baseline, 1 month, 3 months, and 4 months (1 month discontinuation). The assessments included VAS for pain, ISI for insomnia, HAQ for health assessments, and a tender points evaluation. The patients, averaging 54.12 years old with a 3:1 female-to-male ratio, showed significant improvements in VAS, ISI, and HAQ scores relative to their own baselines and a reduction in tender points at 1 and 3 months, which was maintained at 4 months. No adverse events were reported. This study is the first to demonstrate the efficacy of a palmitoylethanolamide and melatonin combination as an adjunct therapy in fibromyalgia, highlighting its potential to reduce pain and improve sleep and quality of life.
纤维肌痛的特征是慢性广泛性疼痛、疲劳和睡眠障碍。最近的理论将纤维肌痛归因于中枢敏化综合征,表明疼痛处理的改变导致了痛觉过敏和感觉异常。目前缺乏标准化的有效治疗方法。棕榈酸乙醇酰胺和褪黑素已在慢性疼痛疾病(包括纤维肌痛)中显示出止痛作用,且安全性良好。我们的开放性研究评估了每日联合使用 1200 毫克棕榈酸乙醇酰胺和 0.2 毫克褪黑素对纤维肌痛患者疼痛、睡眠和生活质量的影响。在 2023 年 6 月至 2024 年 3 月期间,50 名患者(2016 年 ACR 标准)接受了治疗,并在基线、1 个月、3 个月和 4 个月(1 个月停药)时进行了评估。评估包括疼痛的视觉模拟评分(VAS)、失眠的入睡潜伏期指数(ISI)、健康评估的 HAQ 评分和触痛点评估。患者平均年龄为 54.12 岁,女性与男性比例为 3:1,与自身基线相比,VAS、ISI 和 HAQ 评分均有显著改善,且在 1 个月和 3 个月时触痛点减少,4 个月时仍保持。未报告不良反应。这项研究首次证明了棕榈酸乙醇酰胺和褪黑素联合作为纤维肌痛辅助治疗的疗效,突出了其减轻疼痛、改善睡眠和生活质量的潜力。