论文部分内容阅读
作者采用双盲交叉试验法,在12周的时间内,对17例患有双侧性雷诺氏病患者局部应用了硝酸甘油,对该药的控制血管痉挛性发作的疗效给予了评价。所有病人都伴有血管疾病,并且他们继续接受着试验前的其它药物治疗。用等量的羊毛脂把2%的硝酸甘油软膏加以稀释(因先前已研究证明2%的制剂作用太强可引起硝酸盐性头痛)。用羊毛脂作安慰剂,在急性血管痉挛持续发作的过程中,取硝酸甘油软膏剂涂于患者一只手的手指上(范围不超过10cm),每日涂三次。另一只手指涂安慰剂作对照。在用硝酸甘油软膏治疗中,血管痉挛的发作次数明显减少,有13例的症状基本消失,11例疼痛和麻木感消失。而用安慰剂时仅有6例症状基本消失,1例疼痛和麻木症状有所改善,而且安慰剂再次重复应用时效果明显降低。在本试验中,9例病人伴有溃疡。当用硝酸甘油软膏剂时,7例溃疡面缩小且无1例加重:而在用安慰剂时仅有1例症状改善,3例的溃疡面却有加重。
The authors used a double-blind crossover trial to evaluate the efficacy of nitroglycerin topically with 17 patients with bilateral Raynaud’s disease over a 12-week period to control vasospastic seizures. All patients had vascular disease and they continued to receive other medications prior to testing. A 2% nitroglycerin ointment is diluted with the same amount of lanolin (nitrate headaches are caused as a result of previous studies showing that 2% of the formulation is too strong). With lanolin as a placebo, nitroglycerin ointment was applied to the patient’s finger (in the range of 10 cm) three times a day during the sustained episodes of acute vasospasm. The other finger was coated with placebo as a control. In the treatment with nitroglycerin ointment, vasospasm significantly reduced the frequency of seizures, the symptoms of 13 cases disappeared, 11 cases of pain and numbness disappeared. However, only 6 symptoms disappeared in the placebo group, one improved the pain and numbness symptoms, and the placebo effect was significantly reduced after repeated application. In this trial, 9 patients had ulcers. In the case of the nitroglycerin ointment, the ulcer surface was reduced in seven cases and no one was aggravated: in the placebo group, only one symptom was improved and the ulcer surface was aggravated in three cases.