背景:痛风是由高尿酸水平引发的,并引起炎症,疼痛,生活质量受损。浸入20-30°C的水中可减少关节炎的炎症和疼痛。然而,在20-30°C的水中浸泡与尿酸水平和核苷酸结合结构域(NOD)样受体蛋白1(NLRP1)炎性体的关系尚未阐明。
目的:我们旨在研究在20-30°C的水中浸泡对尿酸盐水平的影响,NLRP1炎性体,疼痛,急性痛风患者的生活质量。
方法:采用以社区为基础的随机对照试验设计,有2个平行干预组:在20-30°C的水中浸泡(20分钟/天,4周)组和对照组。总的来说,托莫洪市的76名合格参与者,印度尼西亚,使用区组随机化进行分配。我们分析结果(系数。β)和95%置信区间(CI),使用广义估计方程模型。我们使用路径分析分析了中介效应。
结果:在随访2周和第4周时,与对照组相比,发现疼痛明显减轻(β=-2.06[95%CI=-2.67~-1.45];β=-2.42[95%CI=-2.97~-1.87];β=9.93[95%CI=7.02-12.83])。尿酸水平(β=-0.34[95%CI=-0.52~-0.16])在2周随访时降低,但在20-30°C的水中浸泡后,与试验前和对照组相比,NLRP1炎性体没有显著变化。NLRP1炎性体(β=-0.48[95%CI=-0.63~-0.34]);水0.01)和尿酸水平(β=-0.11[95%CI=-0.24~-0.03];p<0.01)对在20-30°C的水中浸泡与4周随访时疼痛之间的联系具有部分间接(中介)作用。
结论:在20-30°C下浸入水中可显著减轻疼痛并提高生活质量。浸泡在20-30°C的水中介导的NLRP1和尿酸盐水平,以减轻疼痛,尽管在随访4周后对NLRP1炎性体浓度没有显着影响,并且仅在浸入20-30°C的水中2周后降低了尿酸水平。
Gout is triggered by high urate levels and causes inflammation, pain, and an impaired quality of life. Immersion in water at 20-30°C reduces inflammation and pain in arthritis. Yet, relationships of immersion in water at 20-30°C with urate levels and the nucleotide-binding domain (NOD)-like receptor protein 1 (
NLRP1) inflammasome have never been clarified.
We aimed to investigate the effects of immersion in water at 20-30°C on urate levels, the NLRP1 inflammasome, pain, and quality of life among acute gout patients.
A community-based randomized control
trial design was used with 2 parallel-intervention groups: immersion in water at 20-30°C (20 min/day for 4 weeks) group and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were assigned using block randomization. We analyze the results (coef. β) and 95% confidence intervals (CIs) using a generalized estimating equation model. We analyzed mediating effects using a path analysis.
Significant pain alleviation (β = -2.06 [95% CI = -2.67∼-1.45]; β = -2.42 [95% CI = -2.97∼-1.87]) and improved quality of life (β = 5.34 [95% CI = 3.12-7.57]; β = 9.93 [95% CI = 7.02-12.83]) were detected at 2 and 4 weeks of follow-up compared to the pre-test and control group. Urate levels (β = -0.34 [95% CI = -0.52∼-0.16]) were reduced at the 2-week follow-up, but there was no significant change in the
NLRP1 inflammasome compared to the pre-test and control group after immersion in water at 20-30°C. Both the
NLRP1 inflammasome (β = -0.48 [95% CI = -0.63∼-0.34]); water 0.01) and urate levels (β = -0.11 [95% CI = -0.24∼-0.03]; p < 0.01) had partial indirect (mediating) effects on the link between immersion in water at 20-30°C and pain at the 4-week follow-up.
Immersion in water at 20-30°C significantly decreased pain and increased the quality of life. Immersion in water at 20-30°C mediated NLRP1 and urate levels to decrease pain, although it had no significant effect on the
NLRP1 inflammasome concentration after 4 weeks of follow-up and reduced urate levels only at 2 weeks after immersion in water at 20-30°C.