Что ж, сначала по третьему пункту, что никаких данных по РДСПКИ.
Остальное потом. Хочу посмотреть на реакцию по этому пункту.
Most of the studies described in this section used combination products containing various proteolytic enzymes plus other substances, such as the bioflavonoid rutin.
Sports Injuries
A double-blind placebo-controlled study of 44 individuals with sports-related ankle injuries found that treatment with proteolytic enzymes resulted in faster healing and reduced the time away from training by about 50%.17 Three other small double-blind studies, involving a total of about 80 athletes, found that treatment with proteolytic enzymes significantly speeded healing of bruises and other mild athletic injuries as compared to placebo.18,19,20 In another double-blind trial, 100 individuals were given an injection of their own blood under the skin to simulate bruising following an injury. Researchers found that treatment with a proteolytic enzyme combination significantly speeded up recovery.21
A double-blind placebo-controlled trial of 71 individuals with finger fractures found that treatment with proteolytic enzymes significantly improved recovery.22
Surgery
Numerous studies have evaluated various proteolytic enzymes as an aid to recovery from surgery, but the results have been mixed.
A double-blind placebo-controlled trial of 80 individuals undergoing knee surgery found that treatment with mixed proteolytic enzymes after surgery significantly improved rate of recovery, as measured by mobility and swelling.23
Another double-blind placebo-controlled trial evaluated the effects of a similar mixed proteolytic enzyme product in 80 individuals undergoing oral surgery.24 The results showed reduced pain, inflammation, and swelling in the treated group as compared to the placebo group. Benefits were also seen in another trial of mixed proteolytic enzymes for dental surgery,36 as well as in one study involving only bromelain.13
A double-blind placebo-controlled study of 204 women receiving episiotomies after childbirth found evidence that a mixed proteolytic enzyme product can reduce inflammation.37 Bromelain was also found effective for reducing inflammation following episiotomy in one double-blind placebo-controlled trial of 160 women,11 but a very similar study found no benefit.38
Other double-blind placebo-controlled studies have found bromelain effective in nasal surgery,25 cataract removal,12 and foot surgery.39 However, a study of 154 individuals undergoing facial plastic surgery found no benefit.40
Osteoarthritis and Other Forms of Chronic Musculoskeletal Pain
Several studies provide preliminary evidence that proteolytic enzymes might be helpful for various forms of chronic pain, including osteoarthritis, back pain, neck pain, and shoulder pain.
For example, a double-blind placebo-controlled trial of 30 individuals with chronic neck pain found that use of a proteolytic enzyme mixture modestly reduced pain symptoms as compared to placebo.41
Other studies enrolling a total of more than 300 individuals compared proteolytic enzymes to the standard anti-inflammatory drug diclofenac for the treatment of shoulder arthritis, back pain and knee arthritis. 42-43 The results showed equivalent benefits.
Bruises
In a controlled study, 74 boxers with bruises on their faces and upper bodies were given bromelain until all signs of bruising had disappeared;26 another 72 boxers were given placebo. Fifty-eight of the group taking bromelain lost all signs of bruising within 4 days, compared to only 10 of the group taking placebo. Unfortunately, this study was apparently not double-blind, meaning that some of its results may have been due to the power of suggestion.
Other studies have found similar benefits.27,28,29 However, not all studies have had positive results.30,31
Shingles (Herpes Zoster)
Herpes zoster (shingles) is an acute, painful infection caused by the varicella-zoster virus, the organism that causes chicken pox. There is some evidence that proteolytic enzymes may be helpful for the initial attack of shingles, for reasons that aren't clear.
A double-blind study of 190 people with shingles compared proteolytic enzymes to the standard antiviral drug acyclovir.32 Participants were treated for 14 days and their pain was assessed at intervals. Although both groups had similar pain relief, the enzyme-treated group experienced fewer side effects.
Similar results were seen in another double-blind study in which 90 individuals were given either an injection of acyclovir or enzymes, followed by a course of oral medication for 7 days.33
1. Kleveland PM, Johannessen T, Kristensen P, et al. Effect of pancreatic enzymes in non-ulcer dyspepsia. A pilot study. Scand J Gastroenterol. 1990;25:298–301.
2. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol . 1988;22:191-203
3. Zuschlag JM. Double-blind clinical study using certain proteolytic enzyme mixtures in karate fighters. Working paper. Mucos Pharma GmbH (Germany).1988;1–5.
4. Baumuller M. The application of hydrolytic enzymes in blunt wounds to the soft tissue and distortion of the ankle joint: a double-blind clinical trial [translated from German]. Allgemeinmedizin. 1990;19:178–182.
5. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J. 1971;45:181–183.
6. Shaw PC. The use of a trypsin-chymotrypsin formulation in fractures of the hand. Br J Clin Pract. 1969;23:25–26.
7. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: a double-blind study. Pa Med. 1965;68:35–37.
8. Rahn HD. Efficacy of hydorlytic enzymes in surgery. Paper presented at: 24th FIMS World Congress of Sports Medicine; May 27–June 1, 1990; Amsterdam.
9. Vinzenz K. Treatment of edema with hydrolytic enzymes in oral surgical procedures [translated from German]. Quintessenz. 1991;42:1053–1064.
10. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain): a controlled study of 53 rhinoplasty cases. Eye Ear Nose Throat Mon. 1962;41:813–817.
11. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275–278.
12. Spaeth GL. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47:634–639.
13. Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant proteolytic enzyme for the control of imflammation and pain. J Dent Med. 1964;19:73–77.
14. Blonstein JL. Control of swelling in boxing injuries. Practitioner. 1969;203:206.
15. Billigmann VP. Enzyme therapy—an alternative in treatment of herpes zoster. A controlled study of 192 patients [translated from German]. Fortschr Med. 1995;113:43–48.
16. Kleine MW, Stauder GM, Beese EW. The intestinal absorption of orally administered hydrolytic enzymes and their effects in the treatment of acute herpes zoster as compared with those of oral acyclovir therapy. Phytomedicine. 1995;2:7–15.
17. Baumuller M. The application of hydrolytic enzymes in blunt wounds to the soft tissue and distortion of the ankle joint: a double-blind clinical trial [translated from German]. Allgemeinmedizin. 1990;19:178–182.
18. Zuschlag JM. Double-blind clinical study using certain proteolytic enzyme mixtures in karate fighters. Working paper. Mucos Pharma GmbH (Germany). 1988;1–5.
19. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J. 1971;45:181–183.
20. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: a double-blind study. Pa Med. 1965;68:35–37.
21. Kleine MW, Pabst H. The effect of an oral enzyme therapy on experimentally produced hematomas [translated from German]. Forum des Prakt und Allgemeinarztes. 1988;27:42, 45–46, 48.
22. Shaw PC. The use of a trypsin-chymotrypsin formulation in fractures of the hand. Br J Clin Pract. 1969;23:25–26.
23. Rahn HD. Efficacy of hydorlytic enzymes in surgery. Paper presented at: 24th FIMS World Congress of Sports Medicine; May 27-June 1, 1990; Amsterdam.
24. Vinzenz K. Treatment of edema with hydrolytic enzymes in oral surgical procedures [translated from German]. Quintessenz. 1991;42:1053–1064.
25. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain): a controlled study of 53 rhinoplasty cases. Eye Ear Nose Throat Mon. 1962;41:813–817.
26. Blonstein JL. Control of swelling in boxing injuries. Practitioner. 1969;203:206. 26. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275–278.
27. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275-278.
28. Spaeth GL. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47:634–639.
29. Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant proteolytic enzyme for the control of imflammation and pain. J Dent Med. 1964;19:73–77.
30. Howat RC, Lewis GD. The effect of bromelain therapy on episiotomy wounds—a double-blind controlled clinical trial. J Obstet Gynaecol Br Commonw. 1972;79:951–953.
31. Gylling U, Rintala A, Taipale S, et al. The effect of a proteolytic enzyme combinate (bromelain) on the postoperative oedema by oral application. A clinical and experimental study. Acta Chir Scand. 1966;131:193–196.
32. Billigmann VP. Enzyme therapy—an alternative in treatment of herpes zoster. A controlled study of 192 patients [translated from German]. Fortschr Med. 1995;113:43–48.