替扎尼定有效治疗肌膜疼痛症候群.docVIP

替扎尼定有效治疗肌膜疼痛症候群 Tizanidine Is Effective in the Treatment of Myofascial Pain Syndrome Gerard A. Malanga, MD, Matthews W. Gwynn, MD, Rachael Smith, DO and Dorothy Miller 肌膜疼痛症候群（Myofascial Pain Syndrome，MPS）治疗困难。本试验对替扎尼定，一种在痉挛和疼痛治疗方面有效的α2肾上腺素能药物，在治疗MPS方面的有效性和安全性进行了评估。招募患MPS持续9周至50周的女性患者（n＝29），平均年龄为37.5岁（范围：20－51岁），已降低了压痛阈值（pressure threshold）。患者用3周时间将服用替扎尼定的剂量逐渐增加到12mg，并维持剂量2周。睡眠通过视觉模拟量表（visual analog scale，VAS）评估，疼痛强度通过包括基线水平、第3和5周、停用替扎尼定后1周的VAS、残疾/功能水平、压痛阈值（通过痛觉计测试）的简易McGill调查问卷表进行评估。在第5周时，报告患者和医生的治疗总体评价。24例患者完成了研究。从基线水平到第3周、第5周和停药后，疼痛强度和残疾明显减少（P.001）。在全部研究阶段，压痛阈值和睡眠得到改善（P.001）。89％的患者和79％的医生将替扎尼定缓解疼痛分级为“好”到“极好”。没有严重副作用发生。替扎尼定治疗MPS有效。 关键词：替扎尼定，肾上腺素能的，肌膜疼痛症候群 Myofascial pain syndrome (MPS) is difficult to treat. The efficacy and safety of tizanidine, an alpha2-adrenergic agent with effects on spasticity and pain, in treating MPS was evaluated. Female subjects (n = 29) with MPS of 9 to 52 weeks’ duration and mean age 37.5 (range 20–51) years, who also had reduced pressure thresholds, were enrolled. Subjects were titrated up to 12 mg of tizanidine over 3 weeks and maintained for 2 weeks. Sleep was assessed via visual analog scale (VAS), pain intensity via short form McGill questionnaire including VAS, disability/level of function, and pressure threshold (tested by algometry) at baseline, weeks 3 and 5, and 1 week after tizanidine was discontinued. Patient and physician global assessments of treatment were reported at week 5. Twenty-four subjects completed the study. Pain intensity and disability decreased significantly from baseline at weeks 3 and 5 and after washout (P .001). Pressure threshold and sleep improved for all study periods (P .001). Tizanidine was rated as good to excellent in relieving pain by 89% of subjects and 79% of physicians. No serious adverse events occurred. Tizanidine was effective in the treatment of MPS. Key words: Tizanidine, adrenergic, myofascial pain syndrome 肌膜疼痛症候群（Myofascial Pain Syndrome，MPS）是一种普通人群中非常常见的疾病；患病率为12％[1]。Skootsky等[2]报告一