曲马多治疗类风湿关节炎疼痛患者25例远期疗效观察  

EFFECTS OF LONG TERM THERAPY WITH TRAMADOL IN 25 PATIENTS WITH RHEUMATOID ARTHRITIS

作　　者：徐胜前[1] 刘童[1] 沈晓濛[1] 马喜喜[1] 胡琳玮[1] 彭丽萍[1] 徐建华[1] 

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022

出　　处：《中国疼痛医学杂志》2014年第4期255-258,共4页Chinese Journal of Pain Medicine

摘　　要：目的:探讨曲马多长达1年以上疗程治疗类风湿关节炎(Rheumatoid arthritis,RA)患者的临床疗效和安全性。方法:选择25例活动性RA患者(DAS28≥3.2),在正规RA治疗方案的基础上给予曲马多100 mg/d口服治疗1年以上,以随机数字法随机选择同期30例相匹配的RA患者为对照组,给予正规的RA治疗,但禁止使用曲马多(即非曲马多组),比较两组患者1年治疗后DAS28<3.2的达标率和各次要指标的改善情况,同时观察记录不良事件的发生情况。结果:曲马多组在1年和2年后DAS28<3.2的达标率分别为43.48%(10/23)和45.45%(5/11);均高于对照组36.67%(11/30)和40.00%(6/15),但差异无统计学意义;1年疗程后,曲马多组在视觉模拟评分(visual analogue scale,VAS)、ESR、DAS28积分、HAQ积分和关节功能的构成比上均明显好于对照组,差异有统计学意义(P<0.05);2年疗程后,曲马多组在VAS、HAQ积分和关节功能的构成比上均明显好于对照组,差异有统计学意义(P<0.05)曲马多组有2例患者出现明显的恶心、呕吐和头晕表现,停药后缓解。结论:曲马多治疗RA疼痛患者远期疗效显著,安全性高。Objective：To investigate the clinical efficacy and safety of long term therapy with Tramadol in patients with rheumatoid arthritis （RA）.Methods：Twenty-five patients with active RA （DAS28 ≥ 3.2） were treated with Tramadol （100 mg/d） for a long term of over 1 year combined with disease modifying antirheumatic drugs （DMARDs）.Thirty well-matched RA cases without treatment of Tramadol were randomized as controls.All the clinical and laboratory factors of RA were recorded in details by the rheumatologist.The rate of achieving the target of DAS28 ＜ 3.2 and changes of secondary indicators were analyzed between Tramadol group and control group.Results：The rates of achieving the target of DAS 28 ＜ 3.2 in Tramadol group were 43.48％ （10/23） at 1 year and 45.45％ （5/11） at 2nd year after treatment,which were similar to that in control group,36.67％ （11/30） and 40.00％ （6/15）,respectively.At the end of one-year therapy,VAS score,ESR,DAS28,HAQ and function of joint in Tramadol group improved more significantly compared with control group （P ＜ 0.05）.VAS score,HAQ and function of joint in Tramadol group were also ameliorated greater than in control group after 2 years＇ treatment （P ＜ 0.05）.Obvious nausea,vomiting and dizziness were observed only in two patients with Tramadol,with instant remission after withdrawal of Tramadol.Conclusion：Long term treatment with Tramadol in RA patients has a notable efficacy and a high safety.

关 键 词：类风湿关节炎 曲马多 疗效 安全性 

分 类 号：R593.22[医药卫生—内科学]