Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial
Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial
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DOI：
10.1370/afm.1402
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发表时间：
2012-11-01
影响因子：
4.4
通讯作者：
van der Wouden, Johannes C.
中科院分区：
文献类型：
--
作者：
Schreuder, Ferdinand;Bernsen, Roos M. D.;van der Wouden, Johannes C.
目的：许多非西方移民报告肌肉骨骼疼痛难以治疗。我们研究了高剂量维生素D-3对缺乏维生素D的非西方移民的非特异性持续性肌肉骨骼疾病的影响，并评估了疼痛模式与益处的相关性。方法：我们在2008年2月至2010年2月期间对84名因非特异性肌肉骨骼疼痛就诊全科医生的非西方移民进行了一项半交叉随机对照试验。在基线时，患者被随机分配到安慰剂组或维生素D组（口服150,000 IU维生素D3）；在第6周，原始维生素D组的患者被随机分配第二次接受维生素D（再次）或切换到安慰剂组，而原始安慰剂组的患者全部切换到维生素D组。主要结果是前6周后自我评估的疼痛变化。结果：与安慰剂组相比，维生素D组患者在治疗6周后报告疼痛缓解的可能性显著增加（34.9% vs 19.5%, P = 0.04）。前者也更有可能报告走楼梯的能力得到改善（21.0% vs 8.4%, P = 0.008）。疼痛模式与治疗的成功与否无关。在一个不显著的趋势中，服用维生素D超过12周的患者比服用超过6周的患者更有可能得到改善。结论：大剂量维生素D3治疗持续性非特异性肌肉骨骼疼痛6周后有小的积极作用。未来的研究应侧重于更长时间的随访、更高的补充剂量和心理健康。
PURPOSE Many non-Western immigrants report musculoskeletal pains that are hard to treat. We studied the effect of high-dose vitamin D-3 on nonspecific persistent musculoskeletal complaints in vitamin D deficient non-Western immigrants and assessed correlation of pain patterns with benefit.METHODS We conducted a semi-crossover randomized controlled trial between February 2008 and February 2010 in primary care in 84 non-Western immigrants visiting their general practitioner for nonspecific musculoskeletal pain. At baseline, patients were randomized to placebo or vitamin D (150,000 IU vitamin D3 orally); at week 6, patients in the original vitamin D group were randomized a second time to receive vitamin D (again) or to switch to placebo, whereas patients in the original placebo group were all switched to vitamin D. The main outcome was self-assessed change in pain after the first 6 weeks.RESULTS Patients in the vitamin D group were significantly more likely than their counterparts in the placebo group to report pain relief 6 weeks after treatment (34.9% vs 19.5%, P = .04). The former were also more likely to report an improved ability to walk stairs (21.0% vs 8.4%, P = .008). Pain pattern was not correlated with the success of treatment. In a nonsignificant trend, patients receiving vitamin D over 12 weeks were more likely to have an improvement than patients receiving it over 6 weeks.CONCLUSIONS There is a small positive effect 6 weeks after high-dose vitamin D3 on persistent nonspecific musculoskeletal pain. Future research should focus on longer follow-up, higher supplementation doses, and mental health.