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JAMA Inter Med:阿片类药物对腰痛的影响研究

2016-05-31 Mechront 译 MedSci原创

近期有研究表明,阿片类镇痛药为慢性腰痛患者提供了短期缓解,但是,指南建议的治疗剂量并没有给患者带来显著的临床受益。独立研究人员收集了20项安慰剂对照的随机临床试验数据,以评估阿片类镇痛药对腰背痛的疗效。使用VAS和数值评定量表测量研究的主要结局——疼痛。研究人员还用Oswestry功能障碍指数和罗兰莫里斯残疾问卷得分评估参与者残疾情况。并将疼痛和残疾转换为百分制量表,改善超过20分则视为临床显著有

近期有研究表明,阿片类镇痛药为慢性腰痛患者提供了短期缓解,但是,指南建议的治疗剂量并没有给患者带来显著的临床受益。

独立研究人员收集了20项安慰剂对照的随机临床试验数据,以评估阿片类镇痛药对腰背痛的疗效。使用VAS和数值评定量表测量研究的主要结局——疼痛。研究人员还用Oswestry功能障碍指数和罗兰莫里斯残疾问卷得分评估参与者残疾情况。并将疼痛和残疾转换为百分制量表,改善超过20分则视为临床显著有效。缓解疼痛的结果被归类为短期(不到3个月)、中期(3个月至11个月)和长期(12个月以上)。

结果显示,20个试验中,13个试验评估了对慢性腰背痛的短期影响,无一例是急性腰背痛患者的安慰剂对照试验。调查者注意到,13个试验中近一半的试验中退出率达50%,究其原因是不良事件或缺乏疗效。在短期内,阿片类药物可以适度减轻疼痛,平均差异为-10.1。

根据荟萃回归分析结果,每1个记录单位增加吗啡当量剂量,疼痛缓解增加12分。在评估的剂量范围内(4 mg-24 mg吗啡当量/天),疼痛缓解并没有表现出临床显著性.富集研究设计对结果没有显著影响。

原始出处:

Shaheed CA, et al. Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain.JAMA Int Med. 2016;doi:10.1001/jamainternmed.2016.1251.

Recommended doses of opioid analgesics not linked with clinically meaningful relief for low back pain.Healio.May 30, 2016

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    2016-09-20 wuhai

    不错的

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=131130, encodeId=01d413113011, content=不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d2781928203, createdName=wuhai, createdTime=Tue Sep 20 00:16:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129430, encodeId=cefb129430a7, content=不错哦,会学到很多,喜欢梅斯医学文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 17 11:47:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129108, encodeId=ea94129108b0, content=好文章,赞一个!深入学习,探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Sep 17 08:23:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=108399, encodeId=5e8b1083998d, content=好文,值得学习,赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed Aug 31 13:27:00 CST 2016, time=2016-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253003, encodeId=fd2c125300367, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c83329, createdName=10518093zz, createdTime=Thu Jun 02 05:54:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309017, encodeId=4995130901e34, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Thu Jun 02 05:54:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606932, encodeId=92591606932ee, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Jun 02 05:54:00 CST 2016, time=2016-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88084, encodeId=fb4c88084c6, content=这个不错,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=204, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Wed Jun 01 15:47:00 CST 2016, time=2016-06-01, status=1, ipAttribution=)]
    2016-09-17 1e10c84am36(暂无匿称)

    不错哦,会学到很多,喜欢梅斯医学文章

    0

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    2016-09-17 ylzr123

    好文章,赞一个!深入学习,探究。

    0

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    2016-08-31 ylzr123

    好文,值得学习,赞!

    0

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    2016-06-02 lhlxtx
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    2016-06-01 沉心多思

    这个不错,学习了

    0

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