痛风性关节炎急性发作期对症治疗的效果及安全性研究  

Study on the effect and safety of symptomatic treatment during the acute attack of gouty arthritis

作　　者：王黎锋 王珂 张佳佳 位付涛 韩延明 谢素丽 WANG Li-feng;WANG Ke;ZHANG Jia-jia(Department of Orthopedics,the 988th Hospital of Joint Logistic Support Force,Zhengzhou 450000,China)

机构地区：[1]郑州联勤保障部队第988医院骨科,450000 [2]河南中医药大学医学院,450000

出　　处：《中国实用医药》2024年第2期114-117,共4页China Practical Medicine

摘　　要：目的 探讨痛风性关节炎(GA)急性发作期对症治疗的疗效及安全性。方法 选取97例痛风性关节炎急性发作患者,随机分为A组(33例)、B组(33例)、C组(31例)。A组采用滑膜炎颗粒治疗,B组采用双氯芬酸钠缓释片治疗,C组采用氨酚双氢可待因治疗。对比三组患者治疗前后视觉模拟评分法(VAS)评分、白细胞计数(WBC)、C反应蛋白(CRP)和红细胞沉降率(ESR)及胃肠道反应发生情况。结果 三组治疗前VAS评分对比无统计学意义(P>0.05);治疗后,三组患者的VAS评分均较治疗前下降,且C组VAS评分(1.06±1.03)分低于A组的(2.87±1.69)分和B组的(1.96±0.94)分,B组低于A组,对比有统计学意义(P<0.05)。治疗后,A组和C组胃肠道反应发生率分别为12.12%、19.35%,均低于B组的42.42%,数据有统计学意义(P<0.05)。治疗前三组的WBC、CRP、ESR对比均无统计学意义(P>0.05);治疗后三组的WBC、CRP、ESR均较治疗前下降,且B组CRP(5.60±2.26)mg/L和C组CRP(5.77±2.23)mg/L低于A组的(8.63±3.72)mg/L,数据对比有统计学意义(P<0.05);治疗后三组的WBC、ESR对比数据无统计学意义(P>0.05)。结论 对于痛风性关节炎急性发作患者,氨酚双氢可待因止痛效果优于滑膜炎颗粒和双氯芬酸钠缓释片,但双氯芬酸钠缓释片胃肠道反应高于滑膜炎颗粒及氨酚双氢可待因,临床可根据患者具体情况选择用药。Objective To explore the efficacy and safety of symptomatic treatment during the acute attack of gouty arthritis (GA).Methods 97 patients with acute attack of gouty arthritis were randomly divided into group A (33 cases),group B (33 cases) and group C (31 cases).Group A was treated with synovitis granules,group B was treated with diclofenac sodium sustained-release tablets,and group C was treated with paracetamol and dihydrocodeine tartrate tablets.The visual analogue scale (VAS) score,white blood cell count (WBC),C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) before and after treatment,and gastrointestinal reactions were compared between the two groups.Results There was no statistical significance in VAS scores among the three groups before treatment (P>0.05).After treatment,the VAS score of the three groups was decreased compared with that before treatment,and the VAS score of group C[(1.06±1.03) points]was lower than that of group A[(2.87±1.69) points]and group B[(1.96±0.94) points],and the VAS score of group B was lower than that of group A,with statistical significance (P<0.05).After treatment,the incidence of gastrointestinal reactions in group A and group C were 12.12%and 19.35%,respectively,which were lower than 42.42%in group B,with statistical significance (P<0.05).There was no significant difference in WBC,CRP and ESR among the three groups before treatment (P>0.05).After treatment,the WBC,CRP and ESR of the three groups were all decreased compared with that before treatment,and the CRP of group B[(5.60±2.26) mg/L]and group C[(5.77±2.23) mg/L]were lower than those of group A[(8.63±3.72) mg/L],with statistical significance (P<0.05).There was no significant difference in WBC and ESR among the three groups after treatment (P>0.05).Conclusion For patients with acute attack of gouty arthritis,the analgesic effect of paracetamol and dihydrocodeine tartrate tablets is better than that of synovitis granules and diclofenac sodium sustained-release tablets,and the gastrointestinal reacti

关 键 词：痛风性关节炎 急性发作 滑膜炎颗粒 双氯芬酸钠缓释片 氨酚双氢可待因 

分 类 号：R589.7[医药卫生—内分泌]