尼美舒利治疗骨关节炎和类风湿关节炎的临床疗效

目的：了解尼美舒利治疗骨关节炎（ＯＡ）及类风湿关节炎（ＲＡ）的疗效及副作用。方法：尼美舒利组：ＯＡ和ＲＡ各３０例，予尼美舒利１００ｍｇ，ｐｏ，ｂｉｄ；对照组：ＯＡ和ＲＡ各３０例，予双氯芬酸２５ｍｇ，ｐｏ，ｔｉｄ，或萘普生２５０ｍｇ，ｐｏ，ｂｉｄ，观察４ｗｋ。结果：治疗前后２组病人各项临床指标均有明显改善；而实验室指标改善不明显（Ｐ＞０．０５）。２组总有效率分别是８８％和８５％，差别无显著意义；副作用发生率分别为３％和１３％，差别有显著意义（Ｐ＜０．０５）。结论：尼美舒利抗炎镇痛疗效肯定，副作用较少，是一种安全性较佳的非甾体类消炎止痛药。     

国产尼美舒利治疗类风湿关节炎和骨关节炎

观察国产尼美美舒利对类风湿关节炎和骨关节炎（ＯＡ）的疗效和安全性。方法：选取ＲＡ患者１１２例和ＯＡ患者９１例。口服尼美舒利片１００ｍｇ,ｂｉｄ;对照组口服布洛芬缓释胶囊３００ｍｇ,ｂｉｄ。治疗时间为４周。分别观察治疗前后临床指标和炎性实验指标的变化。     

萘丁美酮与萘普生治疗类风湿关节炎的对比

目的：比较萘丁美酮与奈普生治疗类风湿关节炎（ＲＡ）疗效。方法：萘丁美酮组４４例，服１．０ｇ，ｑｎ，４ｗｋ，萘普生组３２例，服０．２５ｇ，ｂｉｄ，４ｗｋ，用双盲对照法。前组１２例、后组１０例服药延长至０．５ａ。结果：４ｗｋ总有效率前组为６６％，后组４７％，０．５ａ总有效率前组９２％，后组７０％，但均无统计学差异（Ｐ＞０．０５）。结论：２药对ＲＡ的疗效相似，但不良反应胃烧灼感与水肿，萘丁美酮少于萘普生。     

尼美舒利和萘普生治疗骨关节炎的临床试验

目的：比较尼美舒利和萘普生治疗骨关节炎的疗效和安全性。方法：采用随机、双盲或单盲、多中心、对照研究方法。尼美舒利１００例（男性４１例，女性５９例，年龄５４±ｓ１０ａ），萘普生６８例（男性２９例，女性３９例，年龄５３±１２ａ）。尼美舒利口服１００ｍｇ，ｂｉｄ；萘普生口服２５０ｍｇ，ｂｉｄ，疗程２ｗｋ。结果：尼美舒利的总有效率为８３％，萘普生的总有效率为７５％（Ｐ＜０．０５）。不良反应发生率分别为２３％和３２％（Ｐ＞０．０５），以胃肠反应为主。结论：尼美舒利对骨关节炎治疗作用优于萘普生，不良反应发生率与萘普生相近。     

非普拉宗治疗关节病变II期临床试验1000例

目的：分析非普拉宗治疗４种关节病变的疗效及不良反应。方法：１６家医院，按国际公认的诊断标准和疗效判断标准随机观察１０００例，其中类风湿关节炎５０５例，骨关节炎３１６例，风湿热１４７例，痛风关节炎３２例。非普拉宗用量０．２ｇ／次，ｐｏ，ｂｉｄ，４ｗｋ为一个疗程，开放式观察。结果：骨关节炎、类风湿关节炎、风湿热、痛风关节炎的总有效率分别为８２．０％，８４．０％，９６．６％，１００％。胃肠道不良反应率１２．６％，其余均较低。结论：国产非普拉宗的疗效可靠，药物不良反应发生率较低     

雷公藤缓释片与雷公藤片治疗类风湿关节炎的对比

类风湿关节炎１２６例，采用随机单盲法分为２组。治疗组６４例（男性１８例，女性４６例；年龄４６±ｓ１３ａ）采用雷公藤缓释片（ＴＷ－ＳＲ）２片，ｐｏ，ｂｉｄ×４ｗｋ。对照组６２例（男性１８例，女性４４例；年龄４６±１５ａ）采用普通雷公藤片（ＴＷ）２片，ｐｏ，ｔｉｄ×４ｗｋ。结果：总有效率ＴＷ－ＳＲ组和ＴＷ组分别为９４％和９０％，不良反应发生率分别为９％和５６％（Ｐ＜０．０１），表明ＴＷ－ＳＲ优于ＴＷ。     

卡维地洛与拉贝洛尔治疗轻、中度高血压病399例的比较

目的：比较国产卡维地洛与拉贝洛尔降压疗效及安全性。方法：轻、中度高血压病病人３９９例（男性 ２２８例,女性 １７１例;年龄 ５２ ａ± ｓ ９ ａ）,其中２００例采用随机、单盲、平行对照方法,卡维地洛与拉贝洛尔组各 １００例,起始剂量分别为 １０ ｍｇ,ｐｏ,ｂｉｄ与 ５０ ｍｇ,ｐｏ, ｂｉｄ, ２ ｗｋ后按血压决定维持原量或增加到 ２０ ｍｇ,ｐｏ, ｂｉｄ或 １００ ｍｐ,ｐｏ, ｂｉｄ,总疗程 ４ ｗｋ。开放组 １９９例服卡维地洛 １０～２０ ｍｇ,ｐｏ, ｂｉｄ × ４ ｗｂ。其中 ４９例延长到 ６ ｍｏ。结果：随机单盲各１００例用药 １ｗｋ血压、心率均明显下降,治疗 ４ ｗｂ总有效率分别为 ７６％及 ６６％,卡维地洛组优于拉贝洛尔组（ Ｐ＜ ０． ０５）。用卡维地洛共 ２９９例总有效率 ８６． ０％。开放组中 ４９例降压从 ４ ｗｋ～６ ｍｏ呈稳定下降。 ２药不良反应依次为 １５％及１３％,均较轻,可耐受。结论： ２药均是治疗轻、中度高血压病的有效而安全的药物,卡维地洛略优于拉贝洛尔。     

非普拉宗治疗关节病变Ⅲ期临床试验1000例

目的：分析非普拉宗治疗４种关节病变的疗效及不良反应。方法：１６家医院，按国际公认的诊断标准和疗效判断标准随机观察１０００例，其中类风湿关节炎５０５例，骨关节炎３１６例，风湿热１４７例，痛风关节炎３２例。非普拉宗用量０．２ｇ／次，ｐｏ，ｂｉｄ，４ｗｋ为一个疗程，开放式观察。结果：骨关节炎、类风湿关节炎、风湿热、痛风关节炎的总有效率分别为８２．０％，８４．０％，９６．６％，１００％。胃肠道不良反应率１     

民美舒利和萘普生随机双盲对照治疗类风湿关节炎

为比较研究尼美舒利（ＮＩＭ）和萘普生（ＮＡＰ）治疗类风湿关节炎的疗效和安全性，将试验设计为随机、双盲、平行性和多中心的比较研究。试验组病例数为６０例，每次口服尼美舒利１００ｍｇ，每日二次，疗程２周，累积用药４周者２８例；对照组病例数为６１例，每次口服萘普生２５０ｍｇ，每日二次，疗程２周，累积用药４周者２９例。结果表明，２、４周时尼美舒利的总有效率为５３．３３％，６０．７１％，萘普生的总有效率为４７     

单硝酸异山梨酯、卡托普利与呋塞米联合治疗扩张型心肌病心力衰竭

目的：观察单硝酸异山梨酯联合卡托普利、呋塞米治疗扩张型心肌病心力衰竭的疗效。方法：扩张型心肌病心力衰竭病人２６例（男性１８例，女性８例；年龄４５ａ±ｓ７ａ）。以单硝酸异山梨酯２０ｍｇ，ｐｏ，ｂｉｄ；卡托普利６．２５～１２．５ｍｇ，ｐｏ，ｂｉｄ～ｔｉｄ；呋塞米２０ｍｇ，ｐｏ，ｑｄ～ｂｉｄ，２ｗｋ为一个疗程。结果：症状和体征好转；用扇形超声心动图测定ＳＶ，ＣＯ，ＥＦ改善。平均动脉压降低均有显著意义（Ｐ＜０．０５）。心功能（ＮＹＨＡ标准）改善。心率变化不大。总有效率为８１％，未发现严重不良反应。结论：３药联合短程治疗扩张型心肌病心力衰竭有效     

洛索洛芬钠治疗膝骨关节炎的临床研究

目的：评价洛索洛芬钠片(乐松)治疗膝骨关节炎(OA)的疗效和安全性。方法：选取OA病人40例，每组20例，采用随机、开放、对照法，试验组：口服洛索洛芬钠片60mg，3次／d；对照组：口服布洛芬缓释胶囊300mg，2次／d，疗程为4周。分别观察治疗前后临床指标和炎性实验指标的变化及不良反应。结果：比较两组在治疗前后组内膝关节活动痛、15m行走时间、日常活动能力及病人综合评估等方面，均显示有显著性差异；而组间比较均无显著性差异。两组总有效率无显著性差异。结论：洛索洛芬钠对OA的疗效与布洛芬相当，且不良反应更轻。     

精氨洛芬治疗膝骨关节炎有效性和安全性观察

目的：观察精氨洛芬治疗膝骨关节炎（OA）的疗效和安全性。方法：采用开放试验,观察30例膝OA患者应用精氨洛芬（400mg,tid）的疗效和安全性,疗程为14d。主要疗效指标为靶部位患者的总体评价（视觉模拟评分法,VAS）,次要疗效指标包括休息痛指数、活动痛指数、关节压痛指数、关节肿胀指数、医生总体评价和药物起效时间,并对不良事件进行统计记录。结果：治疗前患者的总体VAS评分为（6.62±1.52）,治疗后降低至（3.57±2.36）（P〈0.001）,除关节肿胀指数外的各次要疗效指标在治疗后也有不同程度改善（P〈0.01或P〈0.001）,总有效率为70.0%。不良事件发生率为16.7%,而且均是轻度。结论：精氨洛芬治疗膝骨关节炎有良好的止痛效果,安全性好。     

尼美舒利治疗类风湿关节炎的临床研究

目的　研究新型非甾体类抗炎药尼美舒利治疗类风湿关节炎 (rheumatoidarthritis,RA)的疗效及安全性。方法　在全国范围内组织了开放性、多中心临床试验 ,采用随机试验方法 ,研究了尼美舒利对 6 4 6例RA病人的疗效、耐受性及不良反应。尼美舒利口服 1 0 0mg ,1d 2次 ,疗程为 4wk ,其中30 2例病人连用 8wk。结果　 4wk时治疗 6 4 6例RA病人的总有效率为 84 2 1 % ,8wk时治疗 30 2例病人的总有效率为94 70 %。 4wk时 6 4 6例中不良反应发生率为 1 7 4 9% ,其中 ,2例为重度不良反应 ,1 4例为中度不良反应 ,其余为轻度。 8wk时 30 2例中不良反应发生率为 1 8 5 4 % ,其中 7例为中度不良反应 ,余为轻度。结论　尼美舒利治疗RA疗效明显且安全性较好。     

Lumiracoxib in the treatment of osteoarthritis, rheumatoid arthritis and acute postoperative dental pain: results of three dose-response studies

OBJECTIVES: Overview of three dose-response studies demonstrating the efficacy of lumiracoxib, a novel COX-2 selective inhibitor, for chronic pain associated with osteoarthritis (0A), or rheumatoid arthritis (RA) and acute pain following dental extraction. METHODS: OA and RA: 4-week, randomized, placebo- and active-controlled studies of similar design. Patients (OA, n = 583; RA, n = 571) received lumiracoxib 50 mg, 100 mg or 200 mg twice daily (bid), lumiracoxib 400 mg once daily (od), diclofenac 75 mg bid or placebo. Dental: 12-h, single-center, randomized, placebo- and active-controlled study. Patients (n = 202) received single oral doses of lumiracoxib 100 mg or 400 mg, ibuprofen 400 mg or placebo. Main outcome measures: OA: pain intensity (PI) in the target joint (visual analogue scale [VAS]) and WOMAC score at Week 4; RA: overall PI (VAS) and ACR20 response at Week 4; Dental: difference (PID, categorical and VAS) score over 12h post dose, time to onset of analgesia. RESULTS: Throughout the OA study, all lumiracoxib doses provided superior reductions in PI versus placebo and at Week 4, all lumiracoxib doses provided efficacy similar to each other and to diclofenac. In the RA study, lumiracoxib 100 mg bid, 200 mg bid and 400mg od were significantly better than placebo in PI at Weeks 1 and 2 (all p < 0.05) but demonstrated borderline significance at Week 4 (lumiracoxib 400 mg od, p = 0.06). In pain following dental surgery, PID scores for both lumiracoxib doses were superior to placebo from 1.5 h onwards and always comparable, or superior, to ibuprofen. Lumiracoxib 400 mg had the fastest onset of analgesia, measured as median time to confirmed first perceptible pain relief using the two-stopwatch method (37.4 min, superiority versus placebo, p < 0.001). Lumiracoxib was well tolerated in all studies. CONCLUSIONS: These studies provide initial evidence that lumiracoxib is an effective, well-tolerated agent for the treatment of chronic and acute pain.     

Valdecoxib: a review of its use in the management of osteoarthritis, rheumatoid arthritis, dysmenorrhoea and acute pain

Valdecoxib is an orally administered, highly selective cyclo-oxygenase (COX)-2 inhibitor with anti-inflammatory and analgesic properties. In well designed trials, valdecoxib demonstrated efficacy versus placebo in patients with osteoarthritis (OA), rheumatoid arthritis (RA), primary dysmenorrhoea and postoperative pain. Initial results in patients with migraine headache were promising. The efficacy of valdecoxib appears dose dependent up to 40 mg/day. Valdecoxib 10 mg/day was as effective as naproxen and rofecoxib in improving signs and symptoms of OA. The American College of Rheumatology 20% response rate was similar in recipients of valdecoxib, naproxen and diclofenac in patients with RA. In patients with dysmenorrhoea, valdecoxib 20 or 40 mg up to twice daily provided as effective pain relief as naproxen sodium 550 mg twice daily. In acute post-surgical pain, single-dose valdecoxib 40 mg had a rapid onset of action, provided similar analgesia to oxycodone 10 mg plus paracetamol (acetaminophen) 1000 mg and provided a longer time to rescue medication than rofecoxib or oxycodone/paracetamol after oral surgery. Pre-emptive administration of valdecoxib 10-80 mg was particularly effective in dental pain. Valdecoxib had opioid-sparing effects after hip or knee arthroplasty and reduced pain after laparoscopic cholecystectomy. Valdecoxib is generally well tolerated. The incidence of gastroduodenal ulcers was generally lower than with nonselective NSAIDs (i.e. NSAIDs not specifically developed as selective COX-2 inhibitors). With concomitant aspirin, the ulcer rate in valdecoxib recipients increased significantly, but was still lower than that in recipients of aspirin plus nonselective NSAIDs. In conclusion, valdecoxib, a COX-2-selective inhibitor, is as efficacious in pain relief as nonselective NSAIDs, with better gastrointestinal tolerability. It was as effective in RA, OA and primary dysmenorrhoea (the approved indications) as nonselective NSAIDs and as effective as rofecoxib in RA flare. In acute post-surgical pain, valdecoxib provided similar pain relief to oxycodone/paracetamol, had a long duration of action, a rapid onset of analgesia and was opioid-sparing. Valdecoxib provides a valuable alternative in the treatment of chronic arthritis pain and acute pain.     

塞来昔布治疗类风湿关节炎和骨关节炎有效性和安全性的临床研究

目的评价塞来昔布治疗类风湿关节炎(RA)和骨关节炎(OA)的有效性和安全性。方法采用随机、双盲、双模拟和对照研究的方法,将48例患者分为治疗组24例,其中RA14例,OA10例,每天早、晚各服塞来昔布100mg和安慰剂1片;对照组24例,其中RA13例,OA11例,每天早、晚各服双氯芬酸50mg和安慰剂1片,治疗12周以评价药物的安全性和有效性。结果譹两组患者对关节炎疼痛的评估(VAS)均有明显改变;两组差值为3.0,其95%可信区间(CI)为-14.4~20.4;②患者对疾病的总体评价,两组差值为0.1,其95%CI为-0.39~0.59;譻研究者对疾病的总体评价,两组差值为0.05,其95%CI为-0.59~0.49;譼对照组发生胃肠道不良事件3起,治疗组未报告胃肠道不良事件(Fisher精确概率检验,P=0.233)。结论塞来昔布、双氯酚酸均能显著降低患者对关节炎疼痛的评估,改善患者及研究者对疾病状况的总体评价,塞来昔布具有良好耐受性。     

Celecoxib: a review of its use in osteoarthritis, rheumatoid arthritis and acute pain

Celecoxib is a cyclo-oxygenase (COX) inhibitor that exhibits relative in vitro and ex vivo selectivity for COX-2 over COX-1. Results of randomised double-blind multicentre studies indicate that celecoxib is superior to placebo and has similar efficacy as conventional nonsteroidal anti-inflammatory drugs (NSAIDs) in improving the signs and symptoms of osteoarthritis and rheumatoid arthritis. Analgesic efficacy and improvements in functional status are apparent within 2 weeks of starting therapy and are maintained throughout treatment. Available data suggest that celecoxib has analgesic efficacy in patients with postsurgical dental pain, although this is yet to be confirmed. In patients with osteoarthritis of the knee, celecoxib 100 and 200 mg and naproxen 500 mg twice daily were similarly efficacious and superior to placebo. Once and twice daily celecoxib dosage regimens provided comparable efficacy. Improvements in physical function paralleled those in pain relief. Celecoxib also has efficacy in treating the signs and symptoms of osteoarthritis of the hip. The effects of celecoxib were not diminished in elderly patients with osteoarthritis of the hip or knee. All dosages of celecoxib (100 to 400 mg twice daily) and naproxen 500 mg twice daily produced significant anti-inflammatory and analgesic effects in patients with active rheumatoid arthritis. In patients with stable rheumatoid arthritis, celecoxib 200 mg twice daily showed sustained symptomatic improvements similar to those of twice daily slow-release diclofenac 75 mg over a 24-week period. Celecoxib was well tolerated in clinical trials. Upper gastrointestinal complications occurred in significantly fewer patients treated with twice daily celecoxib 25 to 400 mg than in those receiving comparator NSAIDs. There was no evidence of a dose relationship in endoscopic ulcer development and incidences in celecoxib and placebo recipients were lower than in those receiving twice daily naproxen 500 mg or ibuprofen 800 mg 3 times daily. Conclusions: Celecoxib is the first COX-2 specific inhibitor approved for use in osteoarthritis and rheumatoid arthritis. Celecoxib produces significant improvements in pain and inflammation and these effects are maintained during treatment for up 24 weeks in clinical trials. Studies indicate that celecoxib has similar efficacy to conventional NSAIDs in relieving pain and improving functional status, but is associated with a lower incidence of upper gastrointestinal ulceration and complications. This promising gastrointestinal safety profile, together with sustained symptomatic relief, places celecoxib as a useful alternative for the treatment of osteoarthritis and rheumatoid arthritis, particularly in patients at high risk of developing gastrointestinal events. Although data are encouraging, its place in acute pain states remains to be established.     

萘丁美酮和尼美舒利治疗类风湿关节炎疗效和安全性的比较

目的 :比较 2种非甾类消炎药 (NSAIDs)萘丁美酮和尼美舒利治疗类风湿关节炎 (RA)的疗效和安全性。方法 :6 2例活动性RA病人分为 2组 ,萘丁美酮组 (治疗组 ) 30例 ,给予萘丁美酮 5 0 0mg ,po ,bid ;尼美舒利组 (对照组 ) 32例 ,给予尼美舒利10 0mg ,po ,bid。 2组均给药 4wk。受试前后观察临床和实验室指标的变化。结果 :萘丁美酮组总有效率为 87% ,尼美舒利组总有效率为 83% ,P >0 .0 5。与萘丁美酮治疗有关的不良反应包括 :恶心、胃烧灼感、反酸和嗜睡各 1例 ,不良反应率13% ;尼美舒利组不良反应率为 19% ,P >0 .0 5。结论 :萘丁美酮对RA的疗效和不良反应的发生率均与尼美舒利相似 ,是一种较为有效、安全且服用方便的NSAIDs。