E-& #)08< =rc ( `j ` O #5 l6 =& () %&' C (0 H05. `&(+ `O! & *89 %6

Transcription

1 (&)!) '& & "#$%! - #-1 % /(0 *+, ( "*) +)"* +),-! ". (( %&)! "# /0 (RA) () %&'! " # #$ : #-C& D$.( &?@; ' =&A > 8< =& *89 & :4; 8< 3& *4 -. #-+K.(0 H05 () %&' # A,I J5 %+> C0G C 0F6 E,> 7 &7 () %&' MN& /( # ;0 =& ' DO+, 7 /( 5 3& L ( =& O (ACR)American College of --0+ W--2 #--5 ( -- U Q 7 S T) -- PQ : - 3-& 7 [ QZ ((& 2 Single Blind X&Y # +KO ' () %&' F; Rheumatology #- =-& E-& - _ /(- # ( ' # ;0 =& 3& =0 7 7.(( \;, ] ^I 7 ^-I - -& -@Q.%->& # MN& ( `&(I /$ 0 7 I5 =& 3& # _ 7 + =& b& (I 7 b& 7 M,C1 C+.(( a6 /+K 7 ] - #-,@0 S 7 (-+ - _h /( MY E (M2 _g ±US/d C2 E) #+K : k5 4; 0+ W2 0F6 7 N i I ;0 =& %j 7 %A-2 -&7 #C-2 3& # m2 ECn0 `l@ 0jIl,@2 7 /(, ^ `l@ (+ (C &'.%2 ( O Cn0 MN& 7 (+ =& %j (@ /L E&.( (0 #I2j 0F6 #,>& o =& 7 #1 #., 0,2 # #$ : -.%- (-@ -L () %&' # A,I J5 /( 5 7 #i.%2 #, $ ` O /L ( - I, #5 (0( #+K E& k&,.( (0 + =& # %7 7(+ pi&q () %&' %+> (, ( =rc =& 3& #C& CI.(;,2 > /4 &8< =& =rc s2 E-& #)08< =rc ( `j ` O #5 l6 =& () %&' C (0 H05. `&(+ `O! & *89 %6

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3 / (?@; () =)A p,& #5 (06 L.( hd).%-> O 2 `&G } #5 0o, /4 #5 (Joint Pain Index) 4@ F6 ` (- - `-4@ 0 /( #$ {$ `l9 _ W-q CI `4@ 0 /( %2 c?--+ = U (- =~) %2 (-- (C #$ F ((&(-- =_ s----2, = -0 W-2 #-5 (Joint Sweeling andex),@-2 /(- ---4@ %-2 (- (-C #$ 4@ Wq.( 4; 0+ 7 %N& 7 H 3 0jIl USc_ M2 ] M ) U U_ c 2 Y %-&' #- A,-I PQ (+ (UScd M2 ] (-) %-&' F; ACR + W2 #5 () (- - - (- ' #0 +KO ' (- M-,C5 -C0G -C 4; 0+ #+K 7 & 7 [ QZ.( z) (C,> O =-& 3-& -' # =0 7 7.=&5 \;, ] ^I -0- i ((C@2 ) O % (O> ;0 #- - _ /(- #- =-& E&.=& (9) ( "I 7 -I5 =-& 3& # k&( # 8< E& [ƒ2 (c_) %>& MN& ( `&(I /$ /.&I2 (0) - QZ (+ E& 7.(U~UU) %>& # #- - 9 ((- a-6 - /-+K 7 -] ^-I (-I 7 #-5 -@ M,C5.(( 0 7 (- M-,C5 -r %-j #,@0 S /( (UcU_US).(-C,> O #+K + =& 3& -I ;0 - = -& % -j - # -,@0 S 7 ( -+ (-+ (-C - -0F6 7 N i 0jI-l,@-2-7 /(- -, ^- `l@ 12 %-2 3,-N2 & 3& () %&' C-2-0.%2 #,62 A,I %+$ %U #5 =.C- i #0 " p ( (& (-) %-&' F;- %-$.(-,>- u-@ (7 6 ` + S `O(9 $ ACR 0+ W2 -& `-4@ _ 7 H- %-&' %-N& 7 H 0jIl # -C&O - (% - 2 v - MCP PIP% - & '), - (0- %-IJ (-),5-> (-) M (- -4@ O `l@ A E&.%2 7 3&& w,-2 ' - -.(-C5 -,> - %2 - -?-,; `-9 #-5 -$ l6 Lx- - -qqj -6-2.(-C5?O, #- A,-I I l6 &8< =& 7 - /-+K E&.(Uc) %2 (. () %&' H-' #-C7 &-C& -, /-o (0( =-)A 7 -.(-C5 (_).& 7 #5 9.%-2 Ly () %&' #C7 I C 2 E-& 0- &8-< =-& #-9 E& ( #C& p>] - /AY E& DN5.(z) ( # (& I - #-5 #+K.=C5 #+K #C7 E& =&( ' #- =&5 Dq+ MN& MY =&. ] ^I 7 - #-+K E-&.=,>& %2 6 #., /.&I-2 \i =5 /CI /$ ` &8< =& "I- -0- i ((C@-2 ) O % *89-0E&(A,-2 ), 0&( Lx ( ( 7-6 *8-9 - E& -C.(z) ( Ly (0E)5,2 w-& 8< 3& *4 & &8< =& E-< \-i =-5 /-CI /-$ /.&I2 (C \i 0(2 E, \i 0# ]+ F6 0 {&- 3-C> 0() A> _ ( "I -, 0&(- L ( #5 (C,N0 0 O

4 318/...#$% &'( ) * +) $,-!" 1"4 - #-+K 7 `-IO - /-4; 3& M ($ &8-< =& 7 `IO 0o, M ($.(0(.%-2 (- - 0 &8< =& /( #-+K -& 7 [- (-' %-2( /AY ( *A,6. (& #2 M ($ #+K 7 `IO # %IN c~/s _~ d~ S~ ± /d d~ _d ±U~ U S h~ Sh±U~ ~ S+ +=% /_ c+=%d~ _+= % c~,a-2 -&7 #C2 3& # m2 ECn0 `l@.( (0 C =)A E /4 (' %2( /AY ' /I2j #N&q %2 ( (Mean±SD) + *j -0 #-+K -& 7 [ `IO 0o, *A,6 #-N&q (Paired-t-test) a (%N t) X&Y 7 7 #I-2j E-&.(- -. (t-test) - E %2 ( q C+ P <0.05 ch c~/h _~ d~ _g ±g/d S _h ± US _d hd S ±Uc (+ 7 (M2) E2 E2 E () /( s2, (),5> M %2 ESR s2, ~ S+ CRP (+=%_~/ ) c+=%sh/c _+=%Ug/c S+=%_/! "#$ %& ch U~ c~ ch NSAIDs Mtx Chloroqoin Prednisolon 5 mg/d # $% (Mean ±SD) '( % )' % *) % ' %! "#$ +, - U ±UU cc ± Uc c ± U~ c ± U~ _~ ± UU 4@ F6 cd c ±US ±S ch ± Uh cc ± U S ± S ±h ± h d ± h ±Uh Sc ± US hd ± Ud d ± S h ± ± Ud Ug ± US (0 Joint pain index ± S 4@ F6 h ± h ± (0 Joint swelling index ~ ± cu ± SU (#qo) 0jIl,@2 h ± d ± hp g ± h~ g ± U ~ ± U (0 Morning stiffness

5 // & # '() # # *+ #, -. / # 0+ (*#1 P Value./0! 12! "#$ +, - <0.01 U~ ± h U ± UU _~ ± UU 4@ F6 >0.05 d ± cd US <0.01 h/_ ± d c ± S Ug ± US >0.05 ~/g ±S/ d ± h ± <0.01 hd ± SU ± Uh =0. 1 S ± _c h ± d ~ ± U 0- =-& E,>- 7 #-5 %-2 ' (- - #-$ - -J5 %+> C0G C 0F6 DK E& %jl #5 (0( H05 () %&' # A,I #-5 M-,C5 =& %j 7 #N&q =-& %-j (@ /L E&.( & 0M ($ `- O /-L (- #I2j 0F6 #,>& o -J5 /( #-i %2 #, $ pi&q % (@ L () %&' # A,I =& # %7 7 (+.(( #+K # 0 # 9 #5( ( #5 (0( #+K E& k&, D-$ ;0- =-& - ' 7 (-+ IN K.(Ud) -- -' %+> #$ ` O H05 - (-C 2 ` & ECi #5 (2 rc %& E-& -.(-I () %&' + IY 7 (Ud) H0-5 `O(-9 #- ) 0, -.=-C5- #-l - -$ I-$ ˆ =-&.(C- -6 I2C 9 %+ 7 () (0 P*=0/2 Joint pain index ± S 4@ F6 (0 P*<0.05 Joint swelling index ± SU (#qo) 0jIl,@2 (0 Morning stiffness P*=0/1 Paired-t-test 7 [ `IO 0 #N&q t-test 7 [ #N&q * - I #5 (0( #+K E& k&,.(-;,-2 -> /-4 &8-< =& =rc s2 (- =-rc =-& 3-& () %&' &7 #C2 # m2.%2 #,>& H05 %+> %-$ #i I %$ #i 08< ]+ # %-6 E& =)A (&( &8-< =-& \-i 0(-2 # #$ #C7 (- D-$ -, 0(-C&'> %6 ' & -o D-$ ;0- #- &8-< =-& o 8 %2 (--C \--i 0(--2 " i H0-5 D-$ /-o E-&. 2 0(ƒ@N> %+> #5 &0 E&5 0E&(A,2 ( # %IN =& #+K E&.( %6, w-&,-n.(- -,- 7 H05 M,C5 I ` C 7 H05 #5 (0( ' =-N, -o #- %-2 -I &8-< =-& - - (-I I 22 `, 0&( #5 (0( #+K E& k&, MjC& D-$ ;0- =-& ' 7 (+ IN K 7 %-&.-- ' %+> #$ ` O H (C-2 `- & ECi #5 (2 rc `- O #+K E& #n'.( () %&' + IY

6 320/...#$% &'( ) * +) $,- E-< O % *4 7 (h) (CC5 *4 \i =5 Š % 7 (C.(c~Ug) (C& 0 9 Š- =; ( 3& 0 #2 0 ( i #5 #,;.( I E< E&&$ (,,&7!" (- & H&> 8< *l /+> ( =.9 =5 ' &8< /$ /.&I2 7,.(Uh U ) F6 I E< 0 % (-C _ - (- "I- i E, \i 0# 7 /CI 7! (q # C7 u(c> skoldstam L. Fasting and vegan diet in rheumatoid arthritis. Scand J Rheumatol 1987;15: Nenonen M, Helve T, Hanninen O. Effects of uncooked vegan food---"living food"---on rheumatoid arthritis, a tre month controlled and randomized study. Am J Clin Nutr 1992;56:762 [abstract #48]. 3. Panush RS,Carter RL,Kats P, et al. Diet therapy for rheumatoid arthritis. Arthrit Rheum 1983;26: KjeldsenKragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one year vegetarian diet in rheumatoid arthritis. Lancet 1991;338: Lion A, Kaklamani VG, Koukmantaki Y, et al. Dietary factors in relation to rgeumatoid arthritis: a role for olive oil and cooked vegetables. Am J Clin Nutr 1999;70: Kremer JM, Lawrence DA, Jubiz W, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunological effects. Arthritis Rheum 1990;33: Hafstrom l, Ringertz B, Gyllenhammar H, et al. Effects of fasting on disease activity, neutrophil function, fatty acid composition, and leukotriene biosynthesis in patients with rheumatoid arthritis. Arthritis Rheum 1988;31: Skoldstam L,Magnusson KE. Fasting, intestinal permeability, and rheumatoid arthritis. Rheum Dis Clin North Am 1991;17: [review]. 9. KjeldsenKragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one year vegetarian diet in rheumatoid arthritis. Lancet 1991;338: Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Forre O. Vegetarian diet for patients with rheumatoid arthritis-status: two year after introduction of the diet. Clin Rheumatol 1994;13: KjeldsenKrgh J, Hugen M, Borchgrevink CF, et al. Controlled trial of fasting and one year vegetarian diet in rheumatoid arthritis. Lancet 1991;338: Seignalet J. Diet, fasting, and rheumatoid arthritis. Lancet 1992;339:68-9 [letter]. 13. Panayi GS. Diet, fasting, and rheumatoid arthritis. Lancet 1992;339:69 [letter]. 14. Cordain L, Toohey L, Smith MJ, Hicky MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr 2000;83 (3): Darlington LG,Ramsey NW, Mansfield JR. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986;i: Beri D, Malaviya AN, Shandilya R, Singh RR. Effects of dietary restrictions on disease activity in rheumatoid arthritis. Ann Rheum Dis 1988;47: Heliovaara M, Aho K, Knekt P, et al. Coffee consumption, rheumatoid factor, and the risk of

7 Q/ rheumatoid arthritis. Ann Rheum Dis 2000;59: Jantti J, Seppala E, Vapaatalo H, Isomaki H. Evening promrose oil and olive oil in treatment of rheumatoid arthritis. Clin Rheumatol 1989;8: Kremer JM, Jubiz W, MichalekA, et al. Fishoil fatty acid supplementation in active rheumatoid arthritis. Ann Int Med 1987;106 (4): Kremer JM, Lawrence DA, Jubiz W, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Arthrit Rheum 1990;33 (6): Geusens O, Wouters C, Nijs J, et al. Longterm effect of omega3 fatty acid supplementation in active rheumatoid arthritis. Arthrit Rheum 1994;37: Van der Tempel H, Tulleken JE, Limburg PC, et al. Effects of fish oil supplementation in rheumatoid arthritis. Ann Rheum Dis 1990;49: Perlman, AI, Eisenberg, DM, Panush, RS. Talking with patients about alternative and complementary medicine. Rheum Dis Clin North Am 1999; 25:815.