Multimodal therapies comprising spa applications are widely used as non-pharmaceutical treatment options for musculoskeletal diseases. The purpose of this randomized, controlled, open pilot study was to elucidate the involvement of the endocannabinoid system in a multimodal therapy approach. Twenty-five elderly patients with knee osteoarthritis (OA) received a 2-week spa therapy with or without combination of low-dose radon therapy in the Bad Gastein radon gallery. A 10-point numerical rating scale (pain in motion and at rest), WOMAC questionnaire, and the EuroQol-5D (EQ-5D) questionnaire were recorded at baseline, and during treatment period at weeks one and two, and at 3-month and 6-month follow-ups. Plasma levels of the endocannabinoid anandamide (AEA) were determined at baseline and at 2 weeks, and serum levels of several cartilage metabolism markers at all five time-points. A significant and sustained reduction of self-reported knee pain was observed in the study population, but no further significant effect of the additional radon therapy up and above base therapy. This pain reduction was accompanied by a significant reduction of AEA plasma levels during treatment in both groups. No significant differences were seen in serum marker concentrations between the groups treated with or without radon, but a small reduction of serum cartilage degradation markers was observed during treatment in both groups. This is the first study investigating AEA levels in the context of a non-pharmacological OA treatment. Since the endocannabinoid system represents a potential target for the development of new therapeutics, further studies will have to elucidate its involvement in OA pain.

包括水疗应用在内的多峰疗法被广泛用作肌肉骨骼疾病的非药物治疗选择。这项随机，对照，开放式先导研究的目的是阐明内源性大麻素系统在多模式疗法中的作用。25名老年膝关节骨关节炎（OA）患者在Bad Gastein don画廊接受了为期2周的水疗治疗，有或没有低剂量don治疗的组合。在基线，治疗第一周和第二周以及治疗3个月时，记录10点数字评分量表（运动和休息时的疼痛），WOMAC问卷和EuroQol-5D（EQ-5D）问卷。和6个月的随访。在基线和第2周确定血浆内大麻素类大麻素（AEA）的血浆水平，在所有五个时间点的几种软骨代谢标记物的血清和血清水平。在研究人群中观察到自我报告的膝关节疼痛的持续显着减轻，但是在基础疗法之上和之后的其他ra疗法均未产生进一步的显着效果。两组患者在治疗过程中疼痛的减轻伴随着AEA血浆水平的显着降低。在用或不用ra进行治疗的组之间，血清标志物浓度没有发现显着差异，但是两组在治疗过程中均观察到了血清软骨降解标志物的少量降低。这是第一项在非药物性OA治疗中调查AEA水平的研究。由于内源性大麻素系统代表了开发新疗法的潜在目标，