RESUMEN
In a double-blind, randomized, multicentre clinical study, the efficacy and tolerance of a herbal medicine product, Harpadol (6 capsules/day, each containing 435 mg of powdered cryoground powder Harpagophytum procumbens), was compared with diacerhein 100 mg/day in the treatment, for 4 months, of 122 patients suffering from osteoarthritis of the knee and hip. Assessments of pain and functional disability were made on a 10 cm horizontal visual analogue scale; severity of osteoarthritis was evaluated by Lequesne's index. Spontaneous pain showed a significant improvement during the course of the study and there was no difference in the efficacy of the two treatments. Similarly, there was a progressive and significant reduction in the Lequesne functional index and no statistical difference was found between Harpadol and diacerhein. At completion of the study, patients taking Harpadol were using significantly less NSAIDs and antalgic drugs. The frequency of adverse events was significantly lower in the Harpadol group. The most frequent event reported was diarrhea, occurring in 8.1% and 26.7% of Harpadol and diacerhein patients respectively. The global tolerance assessment by patients at the end of treatment favoured Harpadol. The results of this study demonstrate that Harpadol is comparable in efficacy and superior in safety to diacerhein.
Asunto(s)
Antraquinonas/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Glicósidos , Osteoartritis de la Cadera/tratamiento farmacológico , Osteoartritis de la Rodilla/tratamiento farmacológico , Dolor/prevención & control , Piranos/uso terapéutico , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Piranos/química , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
A small percentage of low back pain sufferers are resistant to the various types of treatment tried and the problem becomes chronic. It is for this severely incapacitated group, threatened by socio-occupational misfortune, that we created: the School for Chronic Low Back Pain Sufferers. One hundred and five patients in whom treatment had failed were included after insurance programmes had agreed to provide cover. The system is of a multidisciplinary nature with hospitalisation for 5 days. The fate of 93 of these patients is known with a mean follow-up of 1 year. Quantified initial evaluation on an obstacle course confirmed that even severe low back pain sufferers were unaware of the basic rules for protection of the spine (mean score of 14/50 on admission). Socio-occupational fate analysed on the basis of a questionnaire showed: a high satisfaction index (90%) regardless of the subsequent outcome, and a correlation between follow-up time after the programme and the decrease in painful attacks (p less than 0.03, r = 0.23) or consumption of medications (p less than 0.01, r = 0.29). The relative simplicity of the system proposed, the situation of therapeutic impasse in which the patients for whom it is intended find themselves, the short time required and the results obtained confirm the importance of this multidisciplinary management approach being able to best envisage the possibilities of rehabilitation of the chronic low back pain sufferer, in particular when there are repeated periods off work.