依托考昔和美洛昔康治疗急性痛风的疗效及安全性  

Evaluation of efficacy and safety of etoricoxib and meloxicam in the treatment of patients with acute gout

作　　者：张瑾[1] 丁健[2] 吴华香[1] 

机构地区：[1]浙江大学医学院附属第二医院免疫风湿科,杭州310009 [2]宁波市医疗中心李惠利医院

出　　处：《中华老年医学杂志》2012年第3期221-224,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨应用环氧化酶2抑制剂依托考昔和美洛昔康治疗患者急性痛风发作的疗效和安全性。方法选择我院诊断为痛风急性发作患者88例，分别给予依托考昔120mg／d（依托考昔组，48例）和美洛昔康15mg／d（美洛昔康组，36例）治疗，共7d，主要疗效依据为第2～5天患者对关节疼痛自我评分（0～4分Likert量表）结果，并监测实验期间的各项指标及不良事件，以评估其安全性。结果疼痛自我评分变化值依托考昔组为（-1．66±0．58）分，优于美洛昔康（-1．38±0．44）分，差异有统计学意义（P=0．018）；依托考昔组不良事件的发生率31．2%（15／48）与美洛昔康组33．3％（12／36）相似，差异无统计学意义（P=1．000）。结论依托考昔120mg／d是治疗急性痛风的有效方案，其疗效优于美洛昔康，总体安全性及耐受性良好。Objective To evaluate the efficacy and safety of etoricoxib and meloxicam in the treatment of patients with acute gout. Methods A randomized, active comparator study was conducted at outpatients and inpatients in our hospital from January 2009 to July 2010. A total of 84 patients aged （63.7±11.0） years with an acute attack of gout were treated with etoricoxib 120 mg/d （n=48）, or meloxicam 15 mg/d （n =36） for 7 d. The patient＇s assessment of joint pain （0-4 point Likert scale） at drug treatment for 2-5 d was considered as the primary efficacy end point, 4 h after firstly taking the drug and 2-8 d after treatment as the secondary efficacy end point. The starting efficacy was determined until pain relieved by patient himself. The safety was assessed by adverse experiences and indexes including leucocyte, platelet, creatinine, uric acid, alanine transaminase （ALT） ,aspartate transaminase （AST） and mean artery pressure（MAP）. Results In 84 patients,3 cases （8.30% ） in meloxicam treatment and 15 cases （31.2 % ） in etoricoxib treatment （among which 13 cases finished treatment） discontinued therapy. The improvement scores of joint pain were （-0.41± 0.35 vs.-0.19±0.30, P=0.005） at 4 hafter firstly taking the drug, （-1.66±0.58 vs-1.38± 0.44,P=0.018）at drug treatment for 2-5 d, （-1.83±0.60 vs. -1.85±0.53, P=0.9） at 2-8 d after treatment, and （-2.64 ± 0.45 vs -2.38 ± 0.37, P = 0. 000） post-treatment higher than pre treatment. The starting time of pain relieving were （4.0 ± 4.6） h in etoricoxib treatment and （12. 1±5.7） h in meloxicam treatment. The levels of leucocyte were decreased after treatment as compared with before treatment in both two drug treatments（P〈0.05）, while no differences were found in platelet,creatinine, uric acid, ALT and AST. MAP after etoricoxib treatment was increased compared with pretreatment （P 〈 0.05）. Drug-related adverse experiences appeared in 15 cases （31.2 % ） in etoricoxib treatment and 12 cases（33.3

关 键 词：痛风 抗痛风药 环氧化酶2抑制剂 

分 类 号：R589.7[医药卫生—内分泌]