巴端金与普瑞巴林治疗纤维肌痛的疗效比较：基于fMRI的RCT探索性分析。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-07-03 DOI:10.1016/j.jpain.2025.105487

Yang Li , Meijuan Long , Yanting Li , Bin Jing , Yidan Wang , Zihao Li , Shiya Wu , Juan Jiao

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引用次数: 0

摘要

以普瑞巴林为对照，观察巴端金治疗纤维肌痛（FM）的有效性和安全性，并探讨其与脑功能的关系。这是一项为期12周的前瞻性、随机、单盲试验，随访36周。104例FM患者随机分为巴端金组和普瑞巴林组。主要结果是疼痛视觉模拟量表评分，次要结果是一系列关于其他常见FM症状的专门评估量表。收集患者治疗前后的功能磁共振成像（fMRI）数据。治疗后，两组在疼痛、疲劳、睡眠、抑郁等方面均有显著改善，除4周时巴端金组的睡眠改善程度低于普瑞巴林组外，效果几乎相同。大多数这些改善在12周的随访中得以维持，疼痛和生活质量的改善持续到36周的随访。探索性fMRI结果显示，对巴端金治疗反应充分的患者海马旁回（PHG）的度中心性（DC）值升高（P < 0.005），且治疗前PHG的度中心性（DC）值与巴端金组整体症状严重程度和睡眠质量改善呈正相关（P < 0.05）。总之，除了失眠，巴端金和普瑞巴林在FM方面都有类似的改善。巴端金可能通过靶向PHG为FM患者的疼痛管理带来新的策略，PHG的DC可能与巴端金的疗效有关。观点：本研究结果表明，巴端金可能为纤维肌痛患者的多学科治疗提供了额外的选择。

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Comparative efficacy of Ba-Duan-Jin and pregabalin in the treatment of fibromyalgia: An RCT with an exploratory analysis based on fMRI

A clinical study used pregabalin as a control to test the effectiveness and safety of Ba-Duan-Jin for fibromyalgia (FM) and explore the relation with brain function. This was a 12-week, prospective, randomized, single-blind trial with 36-week follow-up. A total of 104 FM patients were randomly assigned to Ba-Duan-Jin or pregabalin group. The primary outcome was the pain visual analogue scale score, and the secondary outcome was a series of specialized assessment scales regarding other common FM symptoms. Functional magnetic resonance imaging (fMRI) data of patients before and after treatment were collected. After treatment, both groups showed significant improvements in pain, fatigue, sleep, depression and other aspects, achieving nearly identical results, except that sleep improvement in the Ba-Duan-Jin group was less than that in the pregabalin group at 4 weeks. Most of these improvements were maintained at the 12-week follow-up, with pain and quality of life improvements lasted until 36-week follow-up. The exploratory fMRI results showed elevated degree centrality (DC) values in the parahippocampal gyrus (PHG) of the brain in patients who responded adequately to the treatment with the Ba-Duan-Jin (P < 0.005), and the pre-treatment DC values of the PHG were positively correlated with the improvement in overall symptom severity and sleep quality (P < 0.05) in Ba-Duan-Jin group. In conclusion, aside from insomnia, both Ba-Duan-Jin and pregabalin demonstrated similar improvements in FM. Ba-Duan-Jin may brings new strategies for pain management in FM patients by targeting the PHG, and the DC of PHG may be associated with Ba-Duan-Jin's efficacy.

Perspective

The results of this study demonstrate that the Ba-Duan-Jin may provide additional option for the multidisciplinary management of fibromyalgia patients.

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.