Teh L S, Manning J, Moore T, Tully M P, O'Reilly D, Jayson M I
Rheumatic Diseases Centre, University of Manchester, Salford Royal Hospitals NHS Trust, Hope Hospital.
Br J Rheumatol. 1995 Jul;34(7):636-41. doi: 10.1093/rheumatology/34.7.636.
A randomized, double-blind, placebo controlled, cross-over study was conducted to determine the clinical efficacy of and patient tolerance to sustained-release glyceryl trinitrate (GTN) patches in the treatment of Raynaud's phenomenon. The patients studied were those with primary Raynaud's disease (n = 21) and patients with Raynaud's phenomenon secondary to systemic sclerosis (n = 21). GTN patches (0.2 mg/h) were found to be effective in reducing the number (P < 0.05) and severity of Raynaud's attacks (P < 0.05) in both groups of patients. Objective assessments by infrared thermography did not show any significant improvement when the patients were on GTN patches (P > 0.05). Headaches, refractory to treatment, led to the withdrawal of eight patients from the study and occurred in approximately 80% of the remaining patients. Thus, in spite of the subjective efficacy, the frequent headaches will limit the use of GTN patches in Raynaud's phenomenon. Elucidating the mechanism of action of the beneficial and adverse effects of GTN at the molecular level may shed light on the pathogenesis of Raynaud's phenomenon and its treatment.
进行了一项随机、双盲、安慰剂对照的交叉研究，以确定缓释硝酸甘油（GTN）贴片治疗雷诺现象的临床疗效及患者耐受性。研究对象为原发性雷诺病患者（n = 21）和系统性硬化症继发雷诺现象患者（n = 21）。发现GTN贴片（0.2 mg/h）可有效减少两组患者雷诺发作的次数（P < 0.05）和严重程度（P < 0.05）。患者使用GTN贴片时，红外热成像的客观评估未显示任何显著改善（P > 0.05）。治疗无效的头痛导致8名患者退出研究，且约80%的剩余患者出现头痛。因此，尽管有主观疗效，但频繁的头痛将限制GTN贴片在雷诺现象中的应用。在分子水平阐明GTN有益和不良反应的作用机制，可能有助于揭示雷诺现象的发病机制及其治疗方法。
