van Rij A M, Solomon C, Packer S G, Hopkins W G
Department of Surgery, University of Otago Medical School, Dunedin, New Zealand.
Circulation. 1994 Sep;90(3):1194-9. doi: 10.1161/01.cir.90.3.1194.
The use of repeated intravenous infusions of EDTA, which has become known as "chelation therapy," has been promoted for treating intermittent claudication as well as a wide range of other disorders. Multiple reports of excellent results in large numbers of patients have encouraged the use of this regimen. The lack of well-controlled studies substantiating the benefits of this treatment has limited its use mainly to private clinics. The aim of the study was to assess the benefits of chelation therapy in patients with intermittent claudication.
A double-blind, randomized, controlled trial included 32 patients with intermittent claudication who were randomized to a treatment group (15) and a control group (17). Main outcome measures were subjective and measured walking distances and ankle/brachial pulse indices. Other outcome measures included lifestyle and subjective parameters of improvement, cardiac function, ECG, renal function, hematology, blood glucose, and lipid biochemistry. No clinically significant differences in main outcome measures between chelation therapy and placebo groups were detected up to 3 months after treatment. Measures of mood state, activities of daily living, and quality of life factors were not consistently affected by chelation therapy. An equal proportion (13%) of each group thought that they had received the active agent. The proportion of patients showing an improvement in walking distance was not significantly different between the chelation group (60%) and the control group (59%).
Chelation therapy has no significant beneficial effects over placebo in patients with intermittent claudication.
反复静脉输注乙二胺四乙酸(EDTA),即所谓的“螯合疗法”,已被推广用于治疗间歇性跛行以及多种其他疾病。大量患者取得极佳疗效的多份报告促使人们采用这种治疗方案。由于缺乏充分对照研究来证实这种治疗的益处,其应用主要局限于私人诊所。本研究的目的是评估螯合疗法对间歇性跛行患者的疗效。
一项双盲、随机、对照试验纳入了32例间歇性跛行患者,他们被随机分为治疗组(15例)和对照组(17例)。主要结局指标为主观及测量的步行距离和踝/臂脉搏指数。其他结局指标包括生活方式和改善的主观参数、心功能、心电图、肾功能、血液学、血糖和脂质生物化学。治疗后长达3个月,螯合疗法组与安慰剂组在主要结局指标上未检测到具有临床意义的差异。情绪状态、日常生活活动和生活质量因素的指标并未始终受到螯合疗法的影响。每组中均有相同比例(13%)的患者认为自己接受了活性药物。螯合疗法组(60%)和对照组(59%)中步行距离有所改善的患者比例无显著差异。
对于间歇性跛行患者,螯合疗法相对于安慰剂并无显著有益效果。