WHO monographs on selected medicinal plants - travolekar.ru

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function dimensions of the WOMAC, daily visual analogue scales (VAS)
on pain and physical function, and final overall assessments by both patients
and investigators. The results demonstrated a statistically significant
difference between the subjects who received active treatment and
the placebo group in the WOMAC pain dimension (d = 6.5 mm, 95%
confidence intervals (CI), 0.2–12.7 mm, p = 0.047); the WOMAC pain
score was reduced by 14% from the baseline level after 2 weeks of active
treatment, whereas there was an increase of 2% in the placebo group. The
patient diary VAS confirmed the results, and the final overall assessments
showed superiority of the willow bark extract over the placebo (patients’
assessment, p = 0.0002; investigators’ assessment, p = 0.0073) (19, 20).
A double-blind, randomized, controlled clinical trial assessed the efficacy
of an extract of the bark (containing 17.6% total salicin), at a dose of
240.0 mg per day, in the treatment of patients with chronic arthritic pain.
Eighty-two subjects with chronic arthritic pain were randomly assigned
for 2 months without cross-over to receive either the extract or a placebo.
The results demonstrated a small but statistically significant improvement
in pain symptoms (p < 0.05), although the improvement was less in patients
with osteoarthritis. No other significant changes in any other measures
or in the use of other self-prescribed analgesics were observed (28).
The efficacy of a standardized willow bark extract was investigated in
two randomized, controlled, double-blind trials with follow-up for
6 weeks, in patients with osteoarthritis and rheumatoid arthritis. One
hundred and twenty-seven outpatients with osteoarthritis of the hip or
knee and a pain score of at least 30 mm, and 26 outpatients with active
rheumatoid arthritis were randomly allocated to one of three groups. Patients
in the first group received willow bark extract, corresponding to
240 mg of salicin/day; patients in the second group, diclofenac at a dose of
100 mg/day; and the third group, a placebo (n = 43, 43 and 41, respectively).
The main outcome measure was the pain subscore. In the rheumatoid
arthritis trial, patients were randomly assigned to receive either willow
bark extract, corresponding to 240 mg salicin/day (n = 13) or a
placebo (n = 13). The main outcome measure was the patient’s assessment
of pain rated on a 100-mm visual analogue scale. In the osteoarthritis trial,
pain scores decreased by 8 mm (17%) in the group treated with willow
bark and by 23 mm (47%) in the group treated with diclofenac, compared
with 5 mm (10%) in the patients who received the placebo. The difference
between the scores following treatment with willow bark extract and
treatment with placebo was not statistically significant (–2.8 mm; 95%
CI –12.1 to 6.4 mm; p = 0.55, analysis of covariance (ANCOVA)), but the
difference between the outcomes of treatment with diclofenac and with
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