Adjuvant use of melatonin for treatment of fibromyalgia
Adjuvant use of melatonin for treatment of fibromyalgia
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DOI：
10.1111/j.1600-079x.2010.00836.x
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发表时间：
2011-04-01
影响因子：
10.3
通讯作者：
Gorial, Faiq Isho
中科院分区：
文献类型：
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作者：
Hussain, Saad Abdul-Rehman;Al-Khalifa, Ihab Ibrahim;Gorial, Faiq Isho
纤维肌痛综合征（FMS）是一种慢性肌肉骨骼疾病，其特征是全身性肌肉疼痛，伴有疲劳和特定解剖部位（称为压痛点）的压痛。虽然初步证据表明，褪黑激素可能是有效的治疗疼痛与FMS，没有明确的证据支持这一说法。本研究旨在评估使用不同剂量的褪黑激素，单独或与氟西汀联合治疗FMS的意义。对101例符合FMS美国流变学学会（ACR）标准的患者（95例女性和6例男性）进行了双盲、安慰剂对照临床研究。将患者随机分为4组：A组（24例）单用氟西汀20 mg/d; B组（27例）单用褪黑素5 mg; C组（27例）氟西汀20 mg+褪黑素3 mg; D组（23例）氟西汀20 mg+褪黑素5 mg。两药均于早晚各给药1次，每日1次，共8 wk。在0时和8 wk后，使用纤维肌痛影响问卷（FIQ）对每位患者进行临床评估。使用褪黑激素（3 mg或5 mg/天）与20 mg/天氟西汀联合治疗，与治疗前值相比，FIQ评分的总评分和不同评分均显著降低。总之，褪黑激素单独或与氟西汀联合给药对治疗FMS患者有效。
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder characterized by generalized muscular pain accompanied by fatigue and tenderness at specific anatomic sites called tender points. Although preliminary evidence indicates that melatonin may be effective in treating the pain associated with FMS, no definitive evidence supports this claim. This study was designed to evaluate the significance of using different doses of melatonin, alone or in combination with fluoxetine for the management of FMS. A double-blind, placebo-controlled clinical study was performed on 101 patients (95 women and 6 men) who fulfilled the criteria of the American College of Rheumatology (ACR) of FMS. The patients were randomized into four groups: group A (24 patients) treated with 20 mg/day fluoxetine alone; group B (27 patients) treated with melatonin 5 mg alone; group C (27 patients) treated with 20 mg fluoxetine plus 3 mg melatonin; group D (23 patients) treated with 20 mg fluoxetine plus 5 mg melatonin. Both drugs were given once daily in the morning and night time, respectively, for 8 wk. Each patient was clinically evaluated through direct interview with the patients using the Fibromyalgia Impact Questionnaire (FIQ) at zero time and after 8 wk. Using melatonin (3 mg or 5 mg/day) in combination with 20 mg/day fluoxetine resulted in significant reduction in both total and different components of FIQ score compared to the pretreatment values. In conclusion, administration of melatonin, alone or in a combination with fluoxetine, was effective in the treatment of patients with FMS.