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【drug-news】分析证明软骨素不能缓痛

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http://www.usatoday.com/news/health/2007-04-16-chondroitin-analysis_N.htm
Analysis: Chondroitin does not relieve pain
Updated 4h 20m ago | Comments 12 | Recommend 19 E-mail | Save | Print | Reprints & Permissions |

By Elizabeth Weise, USA TODAY
In another blow to those who swear by chondroitin for arthritis pain, an analysis of 20 studies found no evidence that the popular supplement prevents or reduces joint pain.
"We do not have evidence to suggest that chondroitin has a clinically relevant effect on patients' pain," says author Peter Jüni, head of clinical epidemiology and biostatistics at the University of Bern in Switzerland.

Chondroitin is believed to help draw fluid into the cartilage, making it more flexible.

The paper comes a little more than a year after a major 16-site, $14 million National Institutes of Health study found no clear proof that the popular supplement combo glucosamine and chondroitin reduces joint pain.

The U.S. consumer market for glucosamine and chondroitin pills, almost always sold in combination, was$810 million in 2005, says Katja Rauhala, research manager with the Nutrition Business Journal.

FIND MORE STORIES IN: Nutrition
Today's study is published in the Annals of Internal Medicine. The researchers analyzed chondroitin studies dating to 1970. The 20 clinical trials they studied included 3,846 patients. But early studies tended to involve small numbers of patients and were poorly designed, without proper documentation and analysis, Jüni says.

For that reason, the researchers excluded all but three studies from their analysis. Those three were large, recent and well designed and together cover 40% of all the patients in the 20 trials.

After examining those studies, the Swiss researchers concluded that there is no evidence that chondroitin is unsafe, but also none to suggest that it helps diminish joint pain.

As to why so many patients swear by chondroitin as a treatment, Jüni suggests that osteoarthritis — the degenerative joint disease seen especially in older people — is a condition that does not progress invariably toward more severe symptoms.

"You tend to have severe symptoms, and then you get better again. And if you happen to start chondroitin at the moment of severe disease and then it gets better, you might be convinced that it's the drug, but it's actually the body (healing)," he says.

In an accompanying editorial in the journal, David Felson, an osteoarthritis expert at Boston University, says that despite the findings, some patients are convinced that chondroitin helps, and he believes there's no "harm in encouraging them to continue taking it as long as they perceive a benefit."

Frequent knee pain affects about 25% of adults, half of whom are estimated to have arthritis, Felson says.

One thing the study did not rule out is the possibility that chondroitin may lessen pain in patients with less severe arthritis. The most credible studies tended to include patients with more severe arthritis, says Jüni.

Andrew Shao, vice president of scientific and regulatory affairs with the Council for Responsible Nutrition, a supplement industry group, says he doesn't think the analysis was fair in the criteria it used to exclude numerous studies that found chondroitin beneficial.

"Consumers speak with their wallets," Shao says. "This is not some kind of fad. Consumers are finding benefit."

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2007-04-18 08:01 浏览 : 912 回复 : 2

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2007-04-18 08:21

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• 大量失血输血治疗后会引起急性心梗吗？

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http://www.usatoday.com/news/health/2007-04-16-chondroitin-analysis_N.htm
Analysis: Chondroitin does not relieve pain
分析证明软骨素不能缓痛
By Elizabeth Weise, USA TODAY

In another blow to those who swear by chondroitin for arthritis pain, an analysis of 20 studies found no evidence that the popular supplement prevents or reduces joint pain.
对于那些信赖软骨素可以缓解关节炎疼痛的人们来说，这又是一次打击，因为对20项研究结果分析表明，没有证据显示这一颇受欢迎的补充剂能够预防或缓解关节疼痛。
"We do not have evidence to suggest that chondroitin has a clinically relevant effect on patients' pain," says author Peter Jüni, head of clinical epidemiology and biostatistics at the University of Bern in Switzerland.
“我们没有证据表明软骨素对患者疼痛具有临床相关作用。”瑞士伯尔尼大学临床流行病学和生物统计学主任、本研究作者Peter Jüni说道。
Chondroitin is believed to help draw fluid into the cartilage, making it more flexible.
软骨素被认为有助于软骨吸收液体，使之更加柔软灵活。
The paper comes a little more than a year after a major 16-site, $14 million National Institutes of Health study found no clear proof that the popular supplement combo glucosamine and chondroitin reduces joint pain.
在该文章发表的一年前，NIH的一项由16家单位参与、耗资1千4百万美元的大型研究发现，没有明确证据显示深受欢迎的氨基葡萄糖和软骨素复合增补剂可减缓关节疼痛。
The U.S. consumer market for glucosamine and chondroitin pills, almost always sold in combination, was$810 million in 2005, says Katja Rauhala, research manager with the Nutrition Business Journal.
据《营养商业杂志》研究经理Katja Rauhala称， 2005年美国氨基葡萄糖和软骨素片（通常组合出售）消费市场份额为8亿1千万美元。

Today's study is published in the Annals of Internal Medicine. The researchers analyzed chondroitin studies dating to 1970. The 20 clinical trials they studied included 3,846 patients. But early studies tended to involve small numbers of patients and were poorly designed, without proper documentation and analysis, says.
本研究发表在《内科医学年鉴》上。研究人员对1970年以来有关软骨素的研究进行了分析，所分析的20项临床试验中共计3846名患者。但是，早期的研究往往纳入病例较少且试验设计不周，缺少完整资料和分析，Jüni说道。
For that reason, the researchers excluded all but three studies from their analysis. Those three were large, recent and well designed and together cover 40% of all the patients in the 20 trials.
鉴于此，研究人员仅对其中3项研究进行了分析，该3项研究是最近完成的、规模较大且试验设计周密，病例数占所有20项研究总病例数的40%。
After examining those studies, the Swiss researchers concluded that there is no evidence that chondroitin is unsafe, but also none to suggest that it helps diminish joint pain.
经过分析，瑞士研究人员得出结论说，没有证据表明软骨素是不安全的，但也没有证据显示它有助于减轻关节疼痛。
As to why so many patients swear by chondroitin as a treatment, Jüni suggests that osteoarthritis — the degenerative joint disease seen especially in older people — is a condition that does not progress invariably toward more severe symptoms.
那么为什么这么多患者信赖软骨色的治疗呢？Jüni认为，骨关节炎是一种多见于老年人的退行性关节疾病，并不总是向着更为严重的症状不断发展。
"You tend to have severe symptoms, and then you get better again. And if you happen to start chondroitin at the moment of severe disease and then it gets better, you might be convinced that it's the drug, but it's actually the body (healing)," he says.
“你觉得症状开始严重，但此后又有所好转。如果你正好在症状严重的时候开始服用软骨素，之后有所好转，你可能深信是药物作用使然，其实是身体（自我康复）的结果，”他说道。
In an accompanying editorial in the journal, David Felson, an osteoarthritis expert at Boston University, says that despite the findings, some patients are convinced that chondroitin helps, and he believes there's no "harm in encouraging them to continue taking it as long as they perceive a benefit."
波士顿大学骨关节专家David Felson在该篇文章的编论中指出，不管这些发现如何，某些病人仍深信软骨素有所帮助，并且他认为，“只要患者感到有所受益，鼓励他们继续服用软骨素，并没有什么害处。”
Frequent knee pain affects about 25% of adults, half of whom are estimated to have arthritis, Felson says.
Felson称，约25%的成年人罹患经常性膝关节疼痛之苦，估计其中一半患有关节炎。
One thing the study did not rule out is the possibility that chondroitin may lessen pain in patients with less severe arthritis. The most credible studies tended to include patients with more severe arthritis, says Jüni.
该研究并没有排除软骨素减轻非重度关节炎患者疼痛的可能性，大多数可信的研究往往纳入的是较重度关节炎患者，Jüni说道。
Andrew Shao, vice president of scientific and regulatory affairs with the Council for Responsible Nutrition, a supplement industry group, says he doesn't think the analysis was fair in the criteria it used to exclude numerous studies that found chondroitin beneficial.
营养品安全委员会（补充剂工业组织）科学与管理事务副主任Andrew Shao称，研究者将多项有关软骨素有益的研究排斥在外，所以他认为该分析是不公平的。
"Consumers speak with their wallets," Shao says. "This is not some kind of fad. Consumers are finding benefit."
“消费者用钱包说话，这并非是一种时尚，消费者是在花钱买健康。” Shao说道。

编译：

分析证明软骨素不能缓痛

据《今日美国》4月16日报道，瑞士研究人员对20项研究结果分析表明，没有证据显示颇受欢迎的补充剂软骨素能够预防或缓解关节疼痛。对于那些信赖软骨素可以缓解关节炎疼痛的人们来说，又是一次打击。
本研究发表在《内科医学年鉴》上。在该文章发表的一年前，NIH的一项由16家单位参与、耗资1千4百万美元的大型研究发现，没有明确证据显示深受欢迎的氨基葡萄糖和软骨素复合增补剂可减缓关节疼痛。据称， 2005年美国氨基葡萄糖和软骨素片（通常组合出售）消费市场份额为8亿1千万美元。

瑞士研究人员对1970年以来有关软骨素的研究进行了分析，所分析的20项临床试验中共计3846名患者。但是，早期的研究往往纳入病例较少且试验设计不周，缺少完整资料和分析。鉴于此，研究人员仅对其中3项研究进行了分析，该3项研究是最近完成的、规模较大且试验设计周密，病例数占所有20项研究总病例数的40%。
经过分析，瑞士研究人员得出结论说，没有证据表明软骨素是不安全的，但也没有证据显示它有助于减轻关节疼痛。研究人员同时也指出，该研究并没有排除软骨素减轻非重度关节炎患者疼痛的可能性，大多数可信的研究往往纳入的是较重度关节炎患者。
那么为什么这么多患者信赖软骨色的治疗呢？研究人员认为，骨关节炎是一种多见于老年人的退行性关节疾病，并不总是向着更为严重的症状不断发展。“你觉得症状开始严重，但此后又有所好转。如果你正好在症状严重的时候开始服用软骨素，之后有所好转，你可能深信是药物作用使然，其实是身体（自我康复）的结果，”研究人员说道。
波士顿大学骨关节专家David Felson在该篇文章的编论中指出，不管这些发现如何，某些病人仍深信软骨素有所帮助，并且他认为，“只要患者感到有所受益，鼓励他们继续服用软骨素，并没有什么害处。” Felson称，约25%的成年人罹患经常性膝关节疼痛之苦，估计其中一半患有关节炎。
营养品安全委员会（补充剂工业组织）科学与管理事务副主任Andrew Shao称，研究者将多项有关软骨素有益的研究排斥在外，所以他认为该分析是不公平的。“消费者用钱包说话，这并非是一种时尚，消费者是在花钱买健康。” Shao说道。

2007-04-18 13:22

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