Maurel A, Betrancourt J C, Van Frenkel R, Thuillez C
Laboratoire d'Etude clinique de la Microcirculation, Policlinique du Pr. Portos, CHU Henri-Mondor, Créteil.
J Mal Vasc. 1995;20(2):127-33.
The aim of this multicentre trial involving 136 cardiologists was to evaluate, in double-blind versus placebo design, the vasoactive effect of Buflomedil in out-patients with a very simple cooling-test from a practical standpoint and previously described (1). The authors have selected patients having a basal pulpar temperature below 30 degrees C by cutaneous thermometer and falling after immersion of the contralateral hand in water at 4 degrees C, with out complete recovery during 10 minutes following withdrawal. This study carried out 408 eligible patients with 398 finally included in double-blind period (200 in the Buflomedil group, 198 in the placebo group). After a run-in period of 7 days with placebo in single blind, to evaluate the stability of measures, the patients were then treated with either Buflomedil 600 mg a day or placebo at the same dosage, for 14 days. The patients in both groups had a Raynaud's phenomenon and were heavy smokers (> or = 20 packs/year), having either acrocyanosis or lower limbs arterial occlusive disease. The results have shown, after 14 days of oral treatment an increase of basal temperature of 2.01 degrees C in Buflomedil group, versus only 0.82 degrees C in placebo group. This warming-up give evidence of microcirculatory blood flux increasing. This significant difference between the both groups was the same each measurement time after immersion during the recovery phase. There also was a good parallelism between the cutaneous temperature and the global clinical improvement by visual analogic scale filled out by the investigator (p < or = 0.0001) and the patients (p < or = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
这项涉及136位心脏病专家的多中心试验旨在,从实际角度并参照之前描述的方法(1),以双盲对比安慰剂设计,评估丁咯地尔对门诊患者的血管活性作用,这些患者需进行一项非常简单的冷刺激试验。作者选择了那些经皮温计测量基础牙髓温度低于30摄氏度,且对侧手浸入4摄氏度水中后体温下降,撤出手后10分钟内未完全恢复的患者。该研究共纳入408例符合条件的患者,最终398例进入双盲期(丁咯地尔组200例,安慰剂组198例)。在单盲使用安慰剂的7天导入期以评估测量的稳定性后,患者随后接受每天600毫克丁咯地尔或相同剂量安慰剂治疗,为期14天。两组患者均患有雷诺现象且为重度吸烟者(≥20包/年),伴有手足发绀或下肢动脉闭塞性疾病。结果显示,口服治疗14天后,丁咯地尔组基础体温升高2.01摄氏度,而安慰剂组仅升高0.82摄氏度。这种体温升高证明了微循环血流量增加。在恢复阶段浸入后每个测量时间,两组之间的这一显著差异均相同。研究者填写的视觉模拟量表(p≤0.0001)及患者填写的量表(p≤0.0001)所显示的皮肤温度与整体临床改善情况之间也具有良好的平行性。(摘要截选至250词)