Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지

The Effect of Intravenous Vitamin C in People with Fatigue

피로를 호소하는 환자에서 비타민 C 고용량 정맥 주사의 효과

Jung, Gyou-Chul;Yeom, Chang-Hwan;Cho, Be-Long;Choi, Jong-Soon
정규철;염창환;조비룡;최종순

  • Published : 20060500
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Abstract

Background: Although fatigue is the most common symptom in primary care, both doctors and patients tend to overlook it. According to one study, 27% of the adults felt fatigued for one week and 6% of the adults complained of unexplained fatigue for over two weeks. Stress play an important role in the etiology of fatigue. Thus, antioxidants are currently taken by people who complain of fatigue. Vitamin C is one of the most common antioxidants. We intend to find out whether intrarenous vitamin C is really helpful or not in people who complain of fatigue. Methods: We have investigated 19 outpatients who chiefly complained of fatigue and visited the department of family medicine at one university hospital from July 1, 2004 to Nov 30, 2005. The patients were treated by Vitamin C 10g and Vitamin B complex injection for 4 weeks, and they conducted a questionnaire survey concerning the severity of symptom before and after injection. The questionnaire with 9 questions consisted of 7 score index. The results were statistically analyzed with Wilcoxon Signed Ranks test and a P-value under 0.05 was considered significant. Results: Three patients were males and 16 patients were females. The average age group was 47.7${\pm}$13.6 years. While the fatigue severity score of the patients before vitamin C injection was 5.2 (3.0${\sim}$7.0), the fatigue severity score after injection was 3.3 (1.4${\sim}$4.8), which was significantly decreased (P＜0.0001). Conclusion: We think that the vitamin C intravenous injectioned to people who complained of fatigue was helpful.

연구배경: 피로는 일차 의료에서 가장 흔한 증상이지만 환자나 의사 모두 피로 자체를 간과하는 경향이 있다. 조사에 의하면 성인의 27%가 지난 1주일동안 피로를 느꼈으며, 6%에서는 2주 이상 원인불명의 피로로 고생하고 있다고 한다. 실제로 스트레스가 피로의 중요한 원인 중 하나라고 생각하는 많은 피로 환자들은 항산화제를 복용하고 있고 이 중 가장 대표적인 항산화제가 비타민 C이다. 이에 저자 등은 피로를 호소하는 사람들을 대상으로 비타민 C 고용량 정맥 주사 투여 전후를 비교하여 그 효과를 알아보고자 한다. 방법: 2004년 7월 1일부터 2005년 11월 30일까지 모 대학병원 가정의학과에 피로를 주소로 내원한 환자를 대상으로 주 2회 비타민 C 10 g과 비타민 B군 2 cc를 생리식염수 80 cc에 섞어서 4주간을 투여한 후 설문지를 통해서 호전여부를 보았다. 설문지는 총 9개 문항으로 7점 척도로 구성되어 있다. 통계방법은 Wilcoxon Signed Ranks test를 이용하여 P-value 0.05 이하일 때 의미 있는 것으로 하였다. 결과: 남자가 3명이고, 여자가 16명이며, 평균 연령은 47.7${\pm}$13.6세였다. 비타민 C를 투여하기 전에 환자들의 피로도 점수는 5.2점(3.0${\sim}$7.0)인 반면 투여 후에는 3.3점(1.4${\sim}$4.8)으로 통계학적으로 의미 있게 감소하였다(P＜0.0001). 결론: 피로를 호소하는 사람들에서 비타민 C 고용량 정맥 투여가 도움이 되는 것으로 생각된다.

Keywords

References

  1. Skapinakis P, Lewis G, Meltzer H. Clarifying the relationship between unexplained chronic fatigue and psychiatric morbidity: results from a community survey in Great Britain. Am J Psychiatry 2000;157:1492-8 https://doi.org/10.1176/appi.ajp.157.9.1492
  2. Cathebras PJ, Robbins JM, Kirmayer LJ, Hayton BC. Fatigue in primary care: prevalence, psychiatric comorbidity, illness behaviour and outcome. J Gen Intern Med 1992;7:276-86 https://doi.org/10.1007/BF02598083
  3. Kroenke K, Price R. Symptoms in the community. Prevalence, classification and psychiatric comorbidity. Arch Intern Med 1993;153:2474-80 https://doi.org/10.1001/archinte.153.21.2474
  4. Cairns R, Hotopf M. A systematic review describing the prognosis of chronic fatigue syndrome. Occup Med (Lond) 2005; 55:20-31 https://doi.org/10.1093/occmed/kqi013
  5. Grant JE, Veldee MS, Buchwald D. Analysis of dietary intake and selected nutrient concentrations in patients with chronic fatigue syndrome. J Am Diet Assoc 1996;96:383-6 https://doi.org/10.1016/S0002-8223(96)00104-6
  6. Prinz W, Bortz R, Bregin B, Hersch M. The effect of ascorbic acid supplementation on some parameters of the human immunological defence system. Int J Vitam Nutr Res 1977;47: 248-57
  7. Jones PT, Anderson R. Oxidative inhibition of polymorphonuclear leukocyte motility mediated by the peroxidase/H2O2 /halide system: studies on the reversible nature of the inhibition and mechanism of protection of migratory responsiveness by ascorbate, levamisole, thiamine and cysteine. Int J Immunopharmacol 1983;5:377-89 https://doi.org/10.1016/0192-0561(83)90012-7
  8. Hodges RE, Hood J, Canham JE, Sauberlich HE, Baker EM. Clinical manifestations of ascorbic acid deficiency in man. Am J Clin Nutr 1971;24:432-43 https://doi.org/10.1093/ajcn/24.4.432
  9. Kinsman RA, Hood J. Some behavioral effects of ascorbic acid deficiency. Am J Clin Nutr 1971;24:455-64 https://doi.org/10.1093/ajcn/24.4.455
  10. Heseker H, Kubler W, Pudel V, Westenhoffer J. Psychological disorders as early symptoms of a mild-to-moderate vitamin deficiency. Ann N Y Acad Sci 1992;669:352-7 https://doi.org/10.1111/j.1749-6632.1992.tb17121.x
  11. Gerster H. The role of vitamin C in athletic performance. J Am Coll Nutr 1989;8:636-43 https://doi.org/10.1080/07315724.1989.10720338
  12. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989;46:1121-3 https://doi.org/10.1001/archneur.1989.00520460115022
  13. 송찬회, 정규인. 피로와 우울.불안증 환자에서 Fatigus Severity Scale의 임상적 유용성. 정신신체의학 2001;9: 164-73
  14. Prince MI, Mitchison HC, Ashley D, Burke DA, Edwards N, Bramble MG, et al. Oral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial. Aliment Pharmacol Ther 2003;17:137-43 https://doi.org/10.1046/j.1365-2036.2003.01398.x
  15. Kodama M, Kodama T, Murakami M. The value of the dehydroepiandrosterone-annexed vitamin C infusion treatment in the clinical control of chronic fatigue syndrome (CFS). I. A Pilot study of the new vitamin C infusion treatment with a volunteer CFS patient. In Vivo. 1996;10:575-84
  16. Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, et al. Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Neurosci Lett 2003;335:151-4 https://doi.org/10.1016/S0304-3940(02)01058-3
  17. Gaby AR. Intravenous nutrient therapy: the 'Myers' cocktail'. Altern Med Rev 2002;7:389-403
  18. Werbach MR. Nutritional strategies for treating chronic fatigue syndrome. Altern Med Rev 2000;5:93-108
  19. Kuratsune H, Yamaguti K, Lindh G, Evengard B, Hagberg G, Matsumura K, et al. Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain. Neuroimage 2002;17:1256-65 https://doi.org/10.1006/nimg.2002.1260
  20. Logan AC, Wong C. Chronic fatigue syndrome: oxidative stress and dietary modifications. Altern Med Rev 2001;6:450-9
  21. Jammes Y, Steinberg JG, Mambrini O, Bregeon F, Delliaux S. Chronic fatigue syndrome: assessment of increased oxidative stress and altered muscle excitability in response to incremental exercise. J Intern Med 2005;257:299-310 https://doi.org/10.1111/j.1365-2796.2005.01452.x