PDF(Pubmed)
Abstract：
BACKGROUND: Pain is the most common reason for seeking medical treatment. Despite extensive research efforts and effective analgesics modulating pain, there is still a major therapeutic gap in addressing the root causes of pain. Pain is associated with tissue damage induced by oxidative stress and induction of inflammatory mediators following high consumption of antioxidants. The role of antioxidants in general, and the administration of L-ascorbate in particular, is still controversially discussed and underestimated in the daily clinical practice.
METHODS: The current literature on the therapeutic effect of L-ascorbate, ascorbic acid, and vitamin C on various pain conditions was evaluated against the background of evidence-based medicine. Those articles, obtained from systematic search in PubMed, were critically assessed and rated in terms of evidence level and methodological quality by two independent experts. The primary purpose of this work was to establish specific pain therapy guidance for intravenous L-ascorbate.
RESULTS: A PubMed search revealed 14 suitable articles comprising controlled clinical trials and meta-analyses. An additional ten publications could be identified via secondary literature. There is supporting evidence for the efficacy of ascorbate treatment in inflammatory pain conditions, in the complex regional pain syndrome, in post zoster neuralgia, in neuropathic pain, in post-operative pain conditions, and in tumor-related pain. However, the considered studies differ in the type of administration, in dosage, in duration of treatment, as well as in quality of research. Despite all study heterogeneity, it became evident that research of high scientific quality is in support of the efficacy of L-ascorbate in pain treatment.
CONCLUSIONS: Oxidative stress is present in almost all pain conditions. Because oral administration of most magistral formulas of vitamin C does not provide biological availability, parenteral administration should be preferred and can be supported by an oral dose with high bioavailability on days without intravenous treatment. L-ascorbate should be preferred for parenteral high dosage, rather than ascorbic acid, as it does not release acid valences under physiological conditions.
CONCLUSIONS: L-ascorbate is an effective, safe, and economically favorable integrative treatment option for various pain conditions, addressing the root cause of tissue damage and inflammatory mediator burst.
METHODS: The current literature on the therapeutic effect of L-ascorbate, ascorbic acid, and vitamin C on various pain conditions was evaluated against the background of evidence-based medicine. Those articles, obtained from systematic search in PubMed, were critically assessed and rated in terms of evidence level and methodological quality by two independent experts. The primary purpose of this work was to establish specific pain therapy guidance for intravenous L-ascorbate.
RESULTS: A PubMed search revealed 14 suitable articles comprising controlled clinical trials and meta-analyses. An additional ten publications could be identified via secondary literature. There is supporting evidence for the efficacy of ascorbate treatment in inflammatory pain conditions, in the complex regional pain syndrome, in post zoster neuralgia, in neuropathic pain, in post-operative pain conditions, and in tumor-related pain. However, the considered studies differ in the type of administration, in dosage, in duration of treatment, as well as in quality of research. Despite all study heterogeneity, it became evident that research of high scientific quality is in support of the efficacy of L-ascorbate in pain treatment.
CONCLUSIONS: Oxidative stress is present in almost all pain conditions. Because oral administration of most magistral formulas of vitamin C does not provide biological availability, parenteral administration should be preferred and can be supported by an oral dose with high bioavailability on days without intravenous treatment. L-ascorbate should be preferred for parenteral high dosage, rather than ascorbic acid, as it does not release acid valences under physiological conditions.
CONCLUSIONS: L-ascorbate is an effective, safe, and economically favorable integrative treatment option for various pain conditions, addressing the root cause of tissue damage and inflammatory mediator burst.
摘要：
背景：疼痛是就医的最常见原因。尽管广泛的研究努力和有效的镇痛药调节疼痛，在解决疼痛的根本原因方面仍然存在重大的治疗差距。疼痛与氧化应激诱导的组织损伤和高消耗抗氧化剂后炎症介质的诱导有关。抗氧化剂的作用一般，特别是L-抗坏血酸的给药，在日常临床实践中仍然存在争议和低估。
方法：关于L-抗坏血酸的治疗效果的最新文献，抗坏血酸,在循证医学的背景下评估了维生素C对各种疼痛状况的影响。那些文章,从PubMed的系统搜索中获得，由两名独立专家在证据水平和方法学质量方面进行了严格评估和评级。这项工作的主要目的是建立静脉注射L-抗坏血酸盐的特定疼痛治疗指导。
结果：PubMed搜索显示了14篇合适的文章，包括对照临床试验和荟萃分析。可以通过二级文献确定另外十种出版物。有支持证据证明抗坏血酸治疗在炎性疼痛中的疗效，在复杂的区域疼痛综合征中，在带状疱疹后神经痛中，在神经性疼痛中，在术后疼痛情况下，和肿瘤相关的疼痛。然而,所考虑的研究在给药类型上有所不同，在剂量上，在治疗期间，以及研究质量。尽管所有研究的异质性，很明显，高科学质量的研究支持L-抗坏血酸在疼痛治疗中的功效。
结论：氧化应激几乎存在于所有疼痛中。因为口服大多数地方处方的维生素C不能提供生物利用度，肠胃外给药应该是优选的,并且可以在没有静脉内治疗的情况下通过具有高生物利用度的口服剂量来支持.L-抗坏血酸应优先用于肠胃外高剂量，而不是抗坏血酸，因为它在生理条件下不释放酸价。
结论：L-抗坏血酸是一种有效的，安全,和经济上有利的综合治疗选择各种疼痛的条件，解决组织损伤和炎症介质爆发的根本原因。
方法：关于L-抗坏血酸的治疗效果的最新文献，抗坏血酸,在循证医学的背景下评估了维生素C对各种疼痛状况的影响。那些文章,从PubMed的系统搜索中获得，由两名独立专家在证据水平和方法学质量方面进行了严格评估和评级。这项工作的主要目的是建立静脉注射L-抗坏血酸盐的特定疼痛治疗指导。
结果：PubMed搜索显示了14篇合适的文章，包括对照临床试验和荟萃分析。可以通过二级文献确定另外十种出版物。有支持证据证明抗坏血酸治疗在炎性疼痛中的疗效，在复杂的区域疼痛综合征中，在带状疱疹后神经痛中，在神经性疼痛中，在术后疼痛情况下，和肿瘤相关的疼痛。然而,所考虑的研究在给药类型上有所不同，在剂量上，在治疗期间，以及研究质量。尽管所有研究的异质性，很明显，高科学质量的研究支持L-抗坏血酸在疼痛治疗中的功效。
结论：氧化应激几乎存在于所有疼痛中。因为口服大多数地方处方的维生素C不能提供生物利用度，肠胃外给药应该是优选的,并且可以在没有静脉内治疗的情况下通过具有高生物利用度的口服剂量来支持.L-抗坏血酸应优先用于肠胃外高剂量，而不是抗坏血酸，因为它在生理条件下不释放酸价。
结论：L-抗坏血酸是一种有效的，安全,和经济上有利的综合治疗选择各种疼痛的条件，解决组织损伤和炎症介质爆发的根本原因。
