治療下背部疼痛,熱療效果優於OTC藥物

連續熱敷治療後,效果持續兩天

  2002年5月31日─5月15日的「Spine」雜誌報導的一項為期6個月的前瞻性隨機化試驗的結果報導,較低溫度的熱敷,緩解後背部疼痛的效果,可能優於非處方止痛藥。

  第一作者,美國紐華克市UMDNJ-New Jersey醫學院的Scott F. Nadler, DO,在一篇新聞稿中說:「確認這種治療有效,對於患者是很重要的。這是因為他們獲得了一種不會像止痛劑在不恰當的使用時,有可能導致肝,腎,消化道損傷危險的治療選擇。」

  371位患有急性非特異的後背部疼痛的患者中,有113人被安排接受較低溫度的連續熱敷治療(40攝氏度,8小時/天),113人接受acetaminophen 4000 mg/日治療,106人接受ibuprofen 1200 mg/日治療,20人接受口服安慰劑治療,19人接受未加熱的後背包敷治療。研究者不清楚治療分組情況。

  熱敷治療在治療過程中第1、3、4天時疼痛緩解的情形,以及軀幹側向活動能力方面,都明顯好於ibuprofen或者 acetaminophen治療,傷殘情況明顯較少。熱敷治療第一天肌肉緊張的緩解情形,高於acetaminophen治療(均值 10.5; P = 0.001)。無嚴重副反應,不過ibuprofen治療組副反應發生率最高。

  「連續較低溫度熱敷治療,治療下背部疼痛的效果,比acetaminophen以及ibuprofen治療都要好,」作者寫道:「這種低強度,長時間,可隨身攜帶的熱敷療法的治療效果,有部分是由於持續採用熱療與保持正常的活動量合併作用的結果。」

  Procter & Gamble公司為此次研究提供資金支持,其作者是該公司的雇員而且/或者接受該公司的諮詢費。

Heat Better Than OTC Medications for Low-Back Pain

Effect Lasts 2 Days After Continuous Heat-Wrap Treatment

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

May 31, 2002 -- A low-level heat wrap may be better than over-the-counter pain medications for relieving low back pain, according to results of a 6-month prospective, randomized trial reported in the May 15 issue of Spine.

"Confirming that this treatment is effective is important to patients because it gives them a treatment option that does not have the potential risk to the liver, kidneys, and gastrointestinal tract that can accompany inappropriate analgesic usage," lead author Scott F. Nadler, DO, from the UMDNJ-New Jersey Medical School in Newark, says in a news release.

Of 371 subjects with acute, nonspecific, low-back pain, 113 were assigned to continuous low-level heat wrap therapy (40 degrees C, 8 hours/day), 113 to acetaminophen 4000 mg/day, 106 to ibuprofen 1200 mg/day, 20 to oral placebo, and 19 to unheated back wrap. The investigator was blinded to treatment groups.

Pain relief on days 1, 3, and 4, and lateral trunk flexibility during treatment were significantly higher with the heat wrap than ibuprofen or acetaminophen, and disability was significantly lower. Reduction in muscle stiffness on day 1 was greater with the heat wrap than with acetaminophen (mean 10.5; P = 0.001). None of the adverse events was serious, but the ibuprofen group had the highest rate (10.4%).

"Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain," the authors write. "The therapeutic benefit of the low-intensity, long-duration, wearable heat wrap is due in part to the continuous utilization of heat combined with the ability to maintain normal activity levels."

Procter & Gamble funded this study and employed and/or provided consultant fees to its authors.

© 2002 WebMD Inc. All rights reserved.

    



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minho huang
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