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评估在标准治疗基础上加用嘧啶核苷酸与维生素B1和B12联合用药对疼痛性神经根病的治疗效果及患者生活质量的影响。

Evaluation of the Efficacy of the Addition of a Combination of Pyrimidine Nucleotides and Vitamin B1 and B12 to Standard Treatment in the Management of Painful Radiculopathy and in the Quality of Life of Patients.

作者信息

Monfort Jordi, Carrión-Barberà Irene, Tío Laura, Marante Javier, López Vázquez Alicia, Bas Teresa, Fernandez-Fuente-Burson Lola, Caracuel Miguel A, Oliveros-Cid Antonio, Gallart Virginia, Romera-López Cintia, Román José A, Abejón David, Roca Ruíz Luis Javier, Gurt Alba, Ojeda Fabiola, Grima Pedro, Aldonza Rebeca

机构信息

Departament of Rheumatology, Hospital del Mar, 08003 Barcelona, Spain.

Hospital del Mar Research Institute, 08003 Barcelona, Spain.

出版信息

Nutrients. 2024 Dec 4;16(23):4187. doi: 10.3390/nu16234187.

Abstract

: Radiculopathy leads to pain, consequently reducing patient's quality of life (QoL). Research indicates that certain nucleotides, such as cytidine and uridine, along with vitamins B1 and B12, may help alleviate pain and enhance QoL. This study assessed the impact of adding a supplement containing cytidine and uridine nucleotides and vitamins B1 and B12, alongside standard treatment, on radiculopathy-associated pain. : A multicenter, prospective, two-cohort, randomized, open-label study was conducted. The control group received standard treatment, while the experimental group received standard treatment plus the supplement. The primary endpoint was pain reduction measured by a Visual Analog Scale (VAS). Secondary endpoints included functional improvement (Roland Morris questionnaire), clinical improvement (Clinical Global Impression [CGI] scale), and QoL improvement (EQ-5D-5L questionnaire). : A total of 122 patients were included from 17 centers across Spain. Both groups showed pain improvement, but the VAS reduction (control: 24.58 vs. experimental: 31.35) was not statistically significant. The Roland Morris score decreased significantly in the experimental group (estimate: -1.70, 95% CI -3.29 to -0.10; = 0.038), and these patients were 5 times more likely to progress to a better CGI category (OR = 0.20, 95% CI 0.07 to 0.57; = 0.003). No significant differences were observed in EQ-5D-5L scores or analgesic consumption. : The addition of supplemental pyrimidine nucleotides and vitamins B1 and B12 to standard of care treatment improved radiculopathy functional and clinical outcomes. Regarding pain, however, although there was a numerical improvement, it did not reach statistical significance.

摘要

神经根病会导致疼痛,进而降低患者的生活质量(QoL)。研究表明,某些核苷酸,如胞苷和尿苷,以及维生素B1和B12,可能有助于减轻疼痛并提高生活质量。本研究评估了在标准治疗的基础上添加含有胞苷和尿苷核苷酸以及维生素B1和B12的补充剂对神经根病相关疼痛的影响。

开展了一项多中心、前瞻性、双队列、随机、开放标签研究。对照组接受标准治疗,而实验组接受标准治疗加补充剂。主要终点是通过视觉模拟量表(VAS)测量的疼痛减轻情况。次要终点包括功能改善(罗兰·莫里斯问卷)、临床改善(临床总体印象[CGI]量表)和生活质量改善(EQ-5D-5L问卷)。

西班牙17个中心共纳入122例患者。两组均显示疼痛有所改善,但VAS降低幅度(对照组:24.58 vs.实验组:31.35)无统计学意义。实验组的罗兰·莫里斯评分显著降低(估计值:-L70,95%CI -3.29至-0.10;P = 0.038),且这些患者病情进展至更好CGI类别的可能性高出5倍(OR = 0.20,95%CI 0.07至0.57;P = 0.003)。EQ-5D-5L评分或镇痛药消耗量未观察到显著差异。

在标准护理治疗中添加嘧啶核苷酸以及维生素B1和B12可改善神经根病的功能和临床结局。然而,关于疼痛,尽管有数值上的改善,但未达到统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a94d/11644542/c2513e227881/nutrients-16-04187-g001.jpg

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