小剂量秋水仙碱联合得宝松治疗急性痛风性关节炎的疗效分析  

Analysis on effect of low-dose colchicine combined with diprospan for treating acute gouty arthritis

作　　者：杨彦龙[1] 李小琴[2] 史静[2] 周颖[1] 何光桥[1] 孙明芳[1] 刘重阳[1] 

机构地区：[1]第三军医大学大坪医院风湿免疫科,重庆400042 [2]重庆医科大学附属第一医院检验科,重庆400016

出　　处：《检验医学与临床》2016年第15期2103-2105,2108,共4页Laboratory Medicine and Clinic

基　　金：重庆市渝中区科技计划项目(20140120)

摘　　要：目的分析总结小剂量秋水仙碱联合得宝松(复方倍他米松)肌肉注射治疗急性痛风性关节炎的临床疗效及安全性。方法回顾性分析2012年1月至2015年12月第三军医大学大坪医院收治的61例急性痛风性关节炎患者临床资料,其中治疗组38例采用小剂量秋水仙碱联合单次得宝松肌肉注射治疗方案,对照组23例采用大剂量秋水仙碱治疗方案,治疗1周后复查红细胞沉降率(ESR)、C反应蛋白(CRP)等实验室指标并评估关节肿胀、疼痛改善情况,对两种治疗方案的临床疗效及不良反应进行分析。结果与治疗前比较,治疗1周后治疗组ESR、CRP均明显下降,对照组CRP明显下降,差异均有统计学意义(P<0.05),ESR下降不明显,差异无统计学意义(P>0.05);两组白细胞计数(WBC)和中性粒细胞计数(NEUT)均显著下降;两组患者肿胀关节数(SJC)、压痛关节数(TJC)、受累关节总数及VAS疼痛评分均明显减少,差异均有统计学意义(P<0.05)。两组患者治疗后ESR及CRP下降情况比较,治疗组较对照组下降更明显,差异具有统计学意义(P<0.05)。两组患者治疗后SJC、TJC、受累关节总数及VAS疼痛评分情况比较,差异无统计学意义(P>0.05)。不良反应发生率,对照组为56.52%,治疗组为15.79%,两组比较差异具有统计学意义(P<0.05)。结论小剂量秋水仙碱联合单次得宝松肌肉注射与大剂量秋水仙碱均能有效治疗急性痛风性关节炎,小剂量秋水仙碱联合单次得宝松肌肉注射治疗方案的不良反应率更低,耐受性更好,安全性更高。Objective To analyze and summarize the clinical effect and safety of low‐dose colchicine combined with diprospan （compound betamethasone） by intramuscular injection in treating gouty arthritis .Methods The clinical data in 61 cases of acute gouty arthritis in the Daping Hospital of the Third Military Medical University from January 2012 to December 2015 were retro‐spectively analyzed ,in which the treatment group（38 cases） adopted the scheme of low‐dose colchicine combined with single intra‐muscular injection of diprospan and the control group（23 cases） was treated by the large‐dose colchicines scheme .The laboratory indicators such as ESR ,CRP were re‐detected after 1‐week treatment and the improvement situation of joint swelling and pain was evaluated .The clinical effects and adverse reactions were compared between the two groups .Results Compared with before treat‐ment ,the ESR and CRP levels after 1‐week treatment in the treatment group were significantly decreased ,and CRP in the control group was significantly decreased ,the differences were statistically significant（P〈0 .05） ,the decrease of ESR level was unobvious without statistical difference（P〉0 .05）;WBC and NEUT in the two groups were significantly decreased ,the swollen joint count （SJC） ,tender joint count （TJC） ,involved joint count and visual analogue scale （VAS） pain score were significantly decreased , which had statistical differences between the two groups （P〈 0 .05） .The ESR and CRP levels after treatment in the treatment group was more significant than that in the control group ,the difference was statistically significant（P〈 0 .05） .The situation of SJC ,TJC and involved joints total number and VAS score after treatment had no statistical differences between the two groups（P〉0 .05） .The occurrence rate of adverse reactions was 56 .52% in the control group and 15 .79% in the treatment group ,the differ‐ence was statistically significant （P〈0 .05） .Conclusion Low

关 键 词：关节炎 痛风性 秋水仙碱 倍他米松 治疗 

分 类 号：R259.897[医药卫生—中西医结合]