Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial
Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial
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DOI：
10.1136/ard.56.11.649
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发表时间：
1997-11-01
影响因子：
27.4
通讯作者：
Blake, DR
中科院分区：
文献类型：
--
作者：
Edmonds, SE;Winyard, PG;Blake, DR
目的：维生素E是一种最有效的天然脂溶抗氧化剂，在人体内具有抗炎和镇痛活性。这项双盲随机研究使用了广泛的临床和实验室参数，以调查口服α-生育酚对已经接受抗风湿药物治疗的类风湿性关节炎患者是否有任何额外的抗炎或镇痛作用，或两者兼有。方法-42名患者入选，分别接受剂量为600 mg的α-生育酚(n=20)和安慰剂(n=22)的治疗，剂量为600 mg，每日2次(2×2胶囊)，疗程12周。测量以下参数：(1)三个临床炎症指标-Ritchie关节指数、晨僵持续时间和关节肿胀数；(2)三个疼痛指标-早晨疼痛、晚上疼痛和所选活动后疼痛；(3)血液学和生化指标炎症活动；(4)蛋白质和脂肪氧化修饰的分析。此外，临床炎症指标不受治疗影响。然而，与安慰剂相比，维生素E治疗后的疼痛参数显著降低。结论：初步证据表明，维生素E可能发挥少量但显著的止痛活性，不依赖于外周抗炎效果，但它补充了标准的抗炎治疗。
Objective-Vitamin E, the most potent naturally occurring lipid soluble antioxidant has been suggested to possess both anti-inflammatory and analgesic activity in humans. This double blind and randomised study used a broad spectrum of clinical and laboratory parameters to investigate whether there was any additional anti-inflammatory or analgesic effects, or both, of orally administered alpha-tocopherol in rheumatoid arthritis patients who were already receiving antirheumatic drugs.Methods-Forty two patients were enrolled and treated with alpha-tocopherol (n=20) at a dose of 600 mg twice a day (2 x 2 capsules) or with placebo (n=22) for 12 weeks. The following parameters were measured: (1) Three clinical indices of inflammation-the Ritchie articular index, the duration of morning stiffness, and the number of swollen joints; (2) three measures of pain-pain in the morning, pain in the evening, and pain after chosen activity; (3) haematological and biochemical measures of inflammatory activity; (4) assays for the oxidative modification of proteins and lipids.Results-All laboratory measures of inflammatory activity and oxidative modification were unchanged. Furthermore, the clinical indices of inflammation were not influenced by the treatment. However, the pain parameters were significantly decreased after vitamin E treatment when compared with placebo.Conclusion-The results provide preliminary evidence that vitamin E may exert a small but significant analgesic activity independent of a peripheral antiinflammatory effect, but which complements standard anti-inflammatory treatment.