Lauche Romy, Gräf Nadine, Cramer Holger, Al-Abtah Jallal, Dobos Gustav, Saha Felix J
*Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany †Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia.
Clin J Pain. 2016 Nov;32(11):961-971. doi: 10.1097/AJP.0000000000000352.
Osteoarthritis (OA) of the knee is one of the most common chronic diseases among older adults. This study aimed to test the effects of cabbage leaf wraps (CLWs) in the treatment of symptomatic OA.
Patients with OA of the knee at stages II to III (Kellgren-Lawrence) were randomly assigned to 4 weeks of treatment with CLWs (daily for at least 2h), topical pain gel (TPG) (10 mg diclofenac/g, at least once daily), or usual care (UC). The primary outcome measure was pain intensity (VAS) after 4 weeks. Secondary outcomes included functional disability Western Ontario and McMaster Universities Arthritis Index (WOMAC), quality of life (SF-36), self-efficacy (Arthritis Self-Efficacy Scale-D), physical function (30 s Chair Stand Test), pressure pain sensitivity (PPT), satisfaction, and safety after 4 and 12 weeks.
In total, 81 patients were included in this study (42 women, 65.9±10.3 y). After 4 weeks patients in the CLW group reported significantly less pain compared with those in the UC group (difference, -12.1; 95% [confidence interval] CI, -23.1, -1.0; P=0.033) but not when compared with the TPG group (difference, -8.6; 95% CI, -21.5, 4.4; P=0.190). Significant effects were also found in WOMAC, SF-36, 30-second Chair Stand Test, and PPT scores in the CLW group compared with the UC group. Compared with TPG, effects from CLW were found for WOMAC after 4 weeks and for quality of life after 12 weeks. Patients were satisfied with both active interventions, and except for 2 adverse events in both groups the applications were well tolerated.
CLWs are more effective for knee OA than UC, but not compared with diclofenac gel. Therefore, they might be recommended for patients with OA of the knee. Further research is warranted.
膝关节骨关节炎(OA)是老年人中最常见的慢性疾病之一。本研究旨在测试卷心菜叶包裹疗法(CLWs)对有症状OA的治疗效果。
II至III期(凯尔格伦-劳伦斯分级)膝关节OA患者被随机分配接受为期4周的CLWs治疗(每天至少2小时)、外用止痛凝胶(TPG)(双氯芬酸10毫克/克,每天至少一次)或常规护理(UC)。主要结局指标是4周后的疼痛强度(视觉模拟评分法[VAS])。次要结局包括功能障碍(西安大略和麦克马斯特大学骨关节炎指数[WOMAC])、生活质量(36项简短健康调查量表[SF-36])、自我效能感(关节炎自我效能量表-D)、身体功能(30秒椅子站立试验)、压痛敏感性(压力痛觉阈值[PPT])、4周和12周后的满意度及安全性。
本研究共纳入81例患者(42名女性,65.9±10.3岁)。4周后,CLW组患者报告的疼痛明显少于UC组(差异为-12.1;95%[置信区间]CI为-23.1,-1.0;P=0.033),但与TPG组相比无显著差异(差异为-8.6;95%CI为-21.5,4.4;P=0.190)。与UC组相比,CLW组在WOMAC、SF-36、30秒椅子站立试验和PPT评分方面也有显著效果。与TPG相比,CLW在4周后的WOMAC和12周后的生活质量方面有效果。患者对两种积极干预措施均满意,除两组各有2例不良事件外,两种治疗方法耐受性良好。
CLWs治疗膝关节OA比UC更有效,但与双氯芬酸凝胶相比无差异。因此,对于膝关节OA患者可推荐使用CLWs。有必要进行进一步研究。