Mastalgia cíclica pré-menstrual: placebo versus outras drogas
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Data
2006-08-01
Autores
De Luca, Laurival A. [UNESP]
Gonçalves, Maria de Fátima V. S. [UNESP]
Carvalho, Lídia Raquel de [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Associação Médica Brasileira
Resumo
Os autores definem mastalgia cíclica pré-menstrual, (MCPM), repassam os principais mecanismos do ciclo celular da mama, e com base nestes conhecimentos propõem a sua classificação em três tipos, segundo a fisiologia do ciclo mamário: tipo 1 - caracterizado pela distensão localizada de ductos e adensamento do tecido conjuntivo em volta de pequenas dilatações. tipo II - caracterizado pelo edema intersticial, e tipo III - caracterizado pela combinação dos dois processos etiopatogênicos. OBJETIVO: Por meio de estudo prospectivo, aleatório, triplo cego e controlado, comparar a ação de placebo com associação de vitaminas A-D-E e doses baixas de ácido acetilsalicílico. MÉTODOS: Foram observadas 259 portadoras de MCPM, acompanhadas durante seis meses para estudo comparativo das drogas empregadas no alívio da dor. Destas, foram selecionadas 81 pacientes por critérios rigorosos, divididas em três grupos de 27, que receberam, respectivamente, aspirina, associação de vitaminas e placebo. A dor foi classificada em grau I (sem dor), grau II (dor moderada) e grau III (dor intensa). Os métodos estatísticos realizados mostraram que o número de pacientes em cada grupo era satisfatório. Foi empregado o teste de Tukey para comparação dos resultados e significância a 5%. RESULTADOS: As características clínicas, idade, peso, altura e IMC, antecedentes obstétricos e duração da amamentação foram semelhantes nos três grupos. Houve redução de intensidade da dor nos três grupos, principalmente naquele que recebeu placebo. CONCLUSÃO: O estudo realizado, segundo metodologia aceitável, porque foi prospectivo, controlado, triplo cego e aleatório, não mostrou diferenças significativas no tratamento da mastalgia cíclica pré-menstrual entre aspirina e associação de vitaminas, mas revelou superioridade do placebo.
OBJECTIVES: To compare therapeutic effects of placebo with intake of low doses of acetyl-salysilic acid (aspirin) and a compound of retinol, pyridoxine chlorhydrate and tocopherol acetate. METHODS: The study is a prospective, controlled, triple blinded, randomized trial. From 259 patients, 81 were selected in order to follow rigid criteria of inclusion. They were divided into three groups of 27 patients, taking aspirin, vitamins or placebo respectively. The number of patients in each group was considered satisfactory for statistical analysis. Pain was scored as Grade 1 (without pain), Grade II (moderate pain) and Grade III (severe pain). The Tukey test was applied for comparison of results (statistical significance 5%). RESULTS: Clinical parameters, age, weight, BMI, parity and lactation period were similar for each group. There was a decrease of pain intensity in all groups, that was even more pronounced for the placebo group. DISCUSSION: Emphasis was given to symptomatic treatment of cyclic premenstrual mastalgia with symptoms considered to be the expression of a physiological process that can be treated with simple drugs or placebo. Usual therapeutic approaches with several drugs are criticized, including results and contraindications. CONCLUSION: This study based upon acceptable trial methodology (randomized, triple blinded, placebo controlled, prospective) did not show significant differences in the treatment of cyclic mastalgia.
OBJECTIVES: To compare therapeutic effects of placebo with intake of low doses of acetyl-salysilic acid (aspirin) and a compound of retinol, pyridoxine chlorhydrate and tocopherol acetate. METHODS: The study is a prospective, controlled, triple blinded, randomized trial. From 259 patients, 81 were selected in order to follow rigid criteria of inclusion. They were divided into three groups of 27 patients, taking aspirin, vitamins or placebo respectively. The number of patients in each group was considered satisfactory for statistical analysis. Pain was scored as Grade 1 (without pain), Grade II (moderate pain) and Grade III (severe pain). The Tukey test was applied for comparison of results (statistical significance 5%). RESULTS: Clinical parameters, age, weight, BMI, parity and lactation period were similar for each group. There was a decrease of pain intensity in all groups, that was even more pronounced for the placebo group. DISCUSSION: Emphasis was given to symptomatic treatment of cyclic premenstrual mastalgia with symptoms considered to be the expression of a physiological process that can be treated with simple drugs or placebo. Usual therapeutic approaches with several drugs are criticized, including results and contraindications. CONCLUSION: This study based upon acceptable trial methodology (randomized, triple blinded, placebo controlled, prospective) did not show significant differences in the treatment of cyclic mastalgia.
Descrição
Palavras-chave
Mastalgia, Mastalgia cíclica, Fisiologia da mama, Tratamento da mastalgia, Mastalgia, Mammary cycle, Cyclic mastalgia
Como citar
Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 52, n. 4, p. 265-269, 2006.