口服镇痛药治疗急性肌肉骨骼疼痛的安全性和有效性前瞻性研究

M. T. S. Priya, S. S. Sonia, Padma Sravani Sagi
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摘要

目的:肌肉骨骼疼痛是青少年的一大健康问题,也是临床医生和内科医生面临的一大挑战。本研究旨在评估口服止痛药在治疗该病症方面的有效性和安全性。研究方法在达玛瓦拉姆地区医院(Area Hospital, Dharmavaram)门诊部就诊的 100 名患者中开展了一项关于口服止痛药治疗这种疼痛的前瞻性研究。每组包括 25 名患者;A 组给予曲马多 100 毫克/日,B 组给予扑热息痛 500 毫克/日,C 组给予布洛芬 200 毫克/日,D 组给予双氯芬酸 50 毫克/日。疼痛的严重程度通过视觉模拟量表(VAS)和口头评定量表(VRS)进行评估。数据采用 SPSS-21 版本进行分析。结果纳入分析的受试者人数为 100 人,平均分为 4 组。A 组给予曲马多 100 毫克,疼痛缓解率为 80%VAS,84%VRS。b 组服用扑热息痛 500 毫克,VAS 和 VRS 评分为 40%。c 组服用布洛芬 200 毫克,VAS 和 VRS 分 别为 60%和 68%。D 组给予双氯芬酸 50 毫克/日,疼痛缓解的改善效果更好,即 VAS 为 88%,VRS 为 96%,但 p 值为 0.001,表明差异具有统计学意义。结论在所有 4 组患者中,曲马多和双氯芬酸的反应较好(分别为 80% 和 84%;88% 和 96%)。双氯芬酸是非阿片类药物。因此,考虑到安全性和改善急性肌肉骨骼疼痛的镇痛效果,口服双氯芬酸是首选镇痛药,而不是口服曲马多,后者是一种阿片类药物,其不良反应包括血压升高、引起癫痫发作和成瘾。
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A PROSPECTIVE STUDY OF SAFETY AND EFFICACY OF ORAL ANALGESICS IN THE MANAGEMENT OF ACUTE MUSCULOSKELETAL PAIN
Objective: Musculoskeletal pain is a significant health problem in adolescents and challenging condition for clinicians and physicians. Acute musculoskeletal pain is sudden and severe which lasts less than 12 w. This study was aimed to assess the efficacy safety of oral analgesics in the management of the condition. Methods: A Prospective study on oral analgesics prescribed routinely for this pain was conducted among 100 patients who attended OPD, at Area Hospital, Dharmavaram. 25 patients were included in each group; group a were given tramadol 100 mgOD, group B-paracetmol 500 mgBD, Group C-ibuprofen 200 mgBD and group D-dicolfenac 50 mgBD. The severity of pain assessed by Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). The data was analysed by using SPSS-21version. Results: Number of subjects included in the analysis 100 who were divided equally into 4 groups. The improvement in pain relief as follows-Group a given tramadol 100 mg showed pain relief of 80%VAS and 84%VRS. Group b given paracetmol 500 mgBD-40% by VAS and VRS. Group c given ibuprofen 200 mgBD showed 60% by VAS and 68% by VRS. GROUP D given diclofenac 50 mgBD showed better improvement of pain relief i. e 88% by VAS and 96% by VRS, yet the p-value is 0.001, showing difference statistically significant. Conclusion: Among all 4 groups, Tramadol and Diclofenac showed better response (80% and 84%;88 and 96% respectively). Diclofenac is non-opioid. Hence, considering safety and improvement in pain relief in acute musculoskeletal Pain, Oral Diclofenac is preferred analgesic of choice over oral tramadol, an opioid with an adverse drug reaction profile that includes rising BP, causing seizure and addiction liability.
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