Uncaria Tomentosa (unha de gato) para tratamento da dor em pacientes com endometriose - Ensaio clínico randomizado
Data
2023-11-28
Autores
Kehde, Beatriz Herzog 
Orientadores
Schor, Eduardo
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Endometriose é uma doença que cursa com dor pélvica podendo interferir na
qualidade de vida das pacientes. O tratamento clínico padronizado é anticoncepcional
hormonal, porém, na persistência de sintomas, há procura por outras opções de tratamento,
como fitoterápicos. Atualmente, Uncaria tomentosa (unha-de-gato) é amplamente utilizada,
principalmente para controle álgico, e mostrou ação na endometriose em estudo
experimental, necessitando de avaliação em humanos. Objetivo: Avaliar a dor e qualidade de
vida em pacientes portadoras de endometriose com o uso de extrato de U. tomentosa.
Metodologia: Ensaio clínico randomizado comparando dois grupos, sendo que um recebeu
extrato de U. tomentosa (500mg a cada 8 horas) e o outro, placebo. Foram avaliadas a dor,
pela escala visual analógica de dor (EVA), e a qualidade de vida focada em endometriose (EHP
30 - Endometriosis Health Profile Questionnaire) no tempo inicial (T0) e mensalmente por 3
meses (T1, T2, T3). Resultados: Na comparação da média do escore EVA foi observada uma
redução na média de 7,63 para 5,88 (p = 0,035) no grupo medicamento, associado a correlação
forte entre os tempos T1 e T2 ( =0,742, p<0,05), entre T1 e T3 ( =0,742, p<0,05) e entre T2 e
T3 ( =0,829, p<0,05). Neste grupo também houve queda do escore total do EHP-30. A média
do escore em T0 foi 59,5 caindo para 44,38 em T1 (p=0,23), para 36,25 em T2 (p=0,036) e para
33,88 em T3 (p=0,006), evidenciando melhora na qualidade de vida. Já no grupo placebo,
houve uma correlação forte entre T0 e T1 ( =0,908, p<0,01), porém ela não se manteve ao
longo do tempo na avaliação de dor pela EVA, e pelo EHP-30 houve melhora da qualidade de
vida até o 2º mês, quando teve início uma leve piora. Conclusão: Foi observada a redução de 2
pontos no escore EVA com melhora progressiva com o tempo de uso. Quanto à qualidade de
vida, houve melhora de aproximadamente 50%. Mais estudos serão necessários para tornar
esse fitoterápico um tratamento padrão no arsenal terapêutico para endometriose.
Introduction: Endometriosis is a disease that causes pelvic pain and can interfere with patients' quality of life. The standardized clinical treatment is hormonal contraceptives, but if symptoms persist, other treatment options such as herbal medicine are sought. Currently, Uncaria tomentosa (cat's claw) is widely used mainly for pain control and has shown action on endometriosis in an experimental study, requiring evaluation in humans. Objective: To evaluate pain and quality of life in patients with endometriosis using U. tomentosa extract. Methodology: Randomized clinical trial comparing two groups, one receiving U. tomentosa extract (500mg every 8 hours) and the other receiving placebo. Pain was assessed using the visual analogue pain scale (VAS) and quality of life focused on endometriosis (EHP 30 - Endometriosis Health Profile Questionnaire) at baseline (T0) and monthly for 3 months (T1, T2, T3). Results: When comparing the mean VAS score, a reduction in the mean from 7.63 to 5.88 (p = 0.035) was observed in the medication group, associated with a strong correlation between T1 and T2 (ρ=0.742, p<0 .05), between T1 and T3 (ρ=0.742, p<0.05) and between T2 and T3 (ρ=0.829, p<0.05). In this group, there was also a drop in the total EHP-30 score, the mean score at T0 was 59.5, falling to 44.38 at T1 (p=0.23), to 36.25 at T2 (p=0.036) and to 33.88 at T3 (p=0.006), showing an improvement in quality of life. In the placebo group, there was a strong correlation between T0 and T1 (ρ=0.908, p<0.01), but this was not maintained over time in the assessment of pain using the VAS, and using the EHP-30, there was an improvement in quality of life until the 2nd month when a slight worsening began. Conclusion: A 2-point reduction in the VAS score was observed with progressive improvement over time of use. As for quality of life, there was an improvement of approximately 50%. More studies will be needed to make this herbal medicine a standard treatment in the therapeutic arsenal for endometriosis.
Introduction: Endometriosis is a disease that causes pelvic pain and can interfere with patients' quality of life. The standardized clinical treatment is hormonal contraceptives, but if symptoms persist, other treatment options such as herbal medicine are sought. Currently, Uncaria tomentosa (cat's claw) is widely used mainly for pain control and has shown action on endometriosis in an experimental study, requiring evaluation in humans. Objective: To evaluate pain and quality of life in patients with endometriosis using U. tomentosa extract. Methodology: Randomized clinical trial comparing two groups, one receiving U. tomentosa extract (500mg every 8 hours) and the other receiving placebo. Pain was assessed using the visual analogue pain scale (VAS) and quality of life focused on endometriosis (EHP 30 - Endometriosis Health Profile Questionnaire) at baseline (T0) and monthly for 3 months (T1, T2, T3). Results: When comparing the mean VAS score, a reduction in the mean from 7.63 to 5.88 (p = 0.035) was observed in the medication group, associated with a strong correlation between T1 and T2 (ρ=0.742, p<0 .05), between T1 and T3 (ρ=0.742, p<0.05) and between T2 and T3 (ρ=0.829, p<0.05). In this group, there was also a drop in the total EHP-30 score, the mean score at T0 was 59.5, falling to 44.38 at T1 (p=0.23), to 36.25 at T2 (p=0.036) and to 33.88 at T3 (p=0.006), showing an improvement in quality of life. In the placebo group, there was a strong correlation between T0 and T1 (ρ=0.908, p<0.01), but this was not maintained over time in the assessment of pain using the VAS, and using the EHP-30, there was an improvement in quality of life until the 2nd month when a slight worsening began. Conclusion: A 2-point reduction in the VAS score was observed with progressive improvement over time of use. As for quality of life, there was an improvement of approximately 50%. More studies will be needed to make this herbal medicine a standard treatment in the therapeutic arsenal for endometriosis.
Descrição
Citação
Kehde, Beatriz Herzog. Uncaria Tomentosa (unha de gato) para tratamento da dor em pacientes com endometriose: ensaio clínico randomizado. 2023. 43 f. Dissertação (Mestrado em Ginecologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2023.