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一种改善纤维肌痛患者生活质量的无药物解决方案(Fibrepik):一项多中心、随机、对照有效性试验的研究方案。

A drug free solution for improving the quality of life of fibromyalgia patients (Fibrepik): study protocol of a multicenter, randomized, controlled effectiveness trial.

机构信息

REMEDEE LABS SA, Montbonnot-Saint-Martin, France.

TIMC Laboratory CNRS-UMR 5525, University Grenoble Alpes, Grenoble, France.

出版信息

Trials. 2022 Sep 5;23(1):740. doi: 10.1186/s13063-022-06693-z.

Abstract

BACKGROUND

Fibromyalgia is a form of chronic widespread pain that is defined as a syndrome of chronic symptoms of moderate to severe intensity, including diffuse pain, fatigue, sleep disturbance, cognitive impairment, and numerous somatic complaints. To date, there is no specific drug treatment for fibromyalgia but only symptomatic treatments. A drug free solution based on a wristband that emits millimeter waves associated with a therapeutic coaching program was developed. The application of millimeter waves on an innervated area has been described to have a neuromodulating effect, due to endorphin release stimulation and parasympathetic activation. Coaching is carried out to improve the patient's adherence and to increase compliance and effectiveness of the treatment. Regular use of this solution by fibromyalgia patients is expected to improve sleep quality, reduce anxiety and pain levels, and, at the end, increase the quality of life.

METHODS

This trial is performed over 8 French inclusion centers for a total of 170 patients. The effectiveness of the solution is evaluated according to the primary objective, the improvement of the quality of life measured through the dedicated Fibromyalgia Impact Questionnaire after 3 months. Patients are randomized in two groups, Immediate or Delayed. The Immediate group has access to the solution just after randomization in addition to standard care, while Delayed has access to the standard of care and waits for 3 months to have the solution. The purpose of this methodology is to limit deception bias and facilitate inclusion. The solution consists in using the device for three sessions of 30 min per day and four coaching sessions spread over the first 2 months of wristband usage.

DISCUSSION

The objective is to confirm the effect of the integrative approach based on endorphin stimulation and a therapeutic coaching program in nociplastic pain and specifically for the patient suffering from fibromyalgia. If the effectiveness of the solution is demonstrated, we will be able to respond to the demand of fibromyalgia patients for access to an effective non-medicinal treatment to improve their quality of life.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05058092.

摘要

背景

纤维肌痛是一种慢性广泛性疼痛,其定义为一种综合征,表现为中重度慢性症状,包括弥漫性疼痛、疲劳、睡眠障碍、认知障碍和许多躯体投诉。迄今为止,纤维肌痛没有特定的药物治疗,只有对症治疗。一种基于腕带的无药物解决方案已经开发出来,腕带发出毫米波,并结合治疗指导方案。据描述,在神经支配区域应用毫米波具有神经调节作用,这是由于内啡肽释放刺激和副交感神经激活。指导是为了提高患者的依从性,增加治疗的依从性和效果。预计纤维肌痛患者经常使用这种解决方案可以改善睡眠质量,降低焦虑和疼痛水平,并最终提高生活质量。

方法

该试验在法国的 8 个纳入中心进行,共有 170 名患者。解决方案的有效性根据主要目标进行评估,即 3 个月后通过专用纤维肌痛影响问卷(FIQ)测量的生活质量改善。患者随机分为两组,即即刻组和延迟组。即刻组在随机分组后立即获得解决方案,并接受标准护理,而延迟组接受标准护理,并等待 3 个月才能获得解决方案。这种方法学的目的是限制欺骗偏见并促进纳入。该解决方案包括每天使用设备进行 3 次 30 分钟的治疗,以及在使用腕带的头 2 个月内进行 4 次指导。

讨论

目的是确认基于内啡肽刺激和治疗指导方案的综合方法对神经病理性疼痛的效果,特别是对纤维肌痛患者的效果。如果该解决方案的有效性得到证实,我们将能够满足纤维肌痛患者对有效非药物治疗的需求,以改善他们的生活质量。

试验注册

ClinicalTrials.gov NCT05058092。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a90f/9442919/b7c2c933bc00/13063_2022_6693_Fig1_HTML.jpg

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