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从病例分析安慰剂对照n-of-1局部止痛剂的临床试验治疗周围神经性疼痛:如何提高水平的病例报告的证据吗?——大卫Kopsky研究所神经性疼痛

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案例报告已经被确认为相关和重要元素在推进医学科学知识。在我们研究所神经性疼痛,我们从对称周围神经性疼痛治疗患者,往往对大多数治疗方法。自2010年以来,我们已经开发出大量的复合局部配方包含古典co-analgesics如氯胺酮、巴氯芬和苯妥英难治性患者和案例报告中的结果和病例分析报告。我们能够优化剂量和配方基于病人的反馈。我们的大多数病人报告快速镇痛效果,在20 - 30分钟后应用镇痛膏。案例报告或案例系列被视为最低水平的证据;因此,我们调整我们的方法n-of-1“临床试验”,视为个性化医学的最终战略。为对称的神经性疼痛状态,这是可能的病人可以在治疗比较镇痛反应(或安慰剂)在两脚之间。我们开发了第一单盲安慰剂对照应答器测试,目前正在设计一个双盲placebocontrolled响应测试。这些测试有助于我们更好地识别反应者和排除安慰剂反应者。 Using a placebo in a practical setting however is not done frequently, and the ethical justifications of using such placebo will be presented, as well as the results of single-blind and double-blind response test evaluating the safety and efficacy of phenytoin cream in peripheral neuropathic pain. The above serves to underline the importance of case-reports in the emergence of new insights in medicine. Subsequent to creating skin creams containing set up co-analgesics for off-mark use in fringe neuropathic torment, our underlying methodology was to begin by endorsing one of those creams to patients; for example, amitriptyline 10% cream for the treatment of PDN. One to about fourteen days after the fact a subsequent meeting was masterminded and patients detailed one of the accompanying – an extensive decrease in agony, once in a while a slight decrease in torment, or no reaction by any means. We additionally checked for and recorded any neighborhood or fundamental antagonistic occasions.

大卫Kopsky和Jan M吉宝寻找

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