吲哚美辛栓治疗高热患儿疗效观察

按５（年龄十１）ｍｇ给予５８例高热患儿吲哚美辛肛栓，与ｉｍ常规剂量安痛定的５６例患儿相比较，用药后１，２，４，６，８和１０ｈ两组患儿体温均数有显著差异（Ｐ＜０．０１）。表明吲哚美辛栓退热确实，且应用简便、无痛苦、副作用小。     

高效液相色谱法鉴别未知物中的对乙酰氨基酚及吲哚美辛

本文介绍了一种利用高效液相色谱法 (HPL C)定性分析可能含有对乙酰氨基酚和吲哚美辛等药物的白色片的方法。该方法是基于有些样品用常规检验方法干扰大 ,无法准确判断的前提下而采用的 ,既能将样品中多种成分有效分离 ,准确判断 ,也可以作为未知物定量的参考。1　材料与方法1.     

吲哚美辛栓治疗痛风性关节炎伴高热患者的疗效观察

目的探讨吲哚美辛栓治疗痛风性关节炎伴高热患者的疗效及安全性。方法以我院痛风性关节炎伴高热患者为研究对象。随机分为吲哚美辛组和秋水仙碱组。以视觉模拟评分法(VAS)评价疼痛程度,并监测体温变化,评估治疗过程中皮疹、恶心、呕吐、腹痛、腹泻、出汗药物不良反应。结果①吲哚美辛组在初次服药后2h和服药后6hVAS评分显著低于秋水仙碱组,差异有统计学意义(P<0.01);在服药后6h,吲哚美辛组体温恢复正常,显著低于秋水仙碱组,差异有统计学意义(P<0.05)。②吲哚美辛组皮疹、恶心呕吐、腹泻等方面副作用显著低于秋水仙碱组,差异有统计学意义(P<0.05);吲哚美辛组出汗副作用显著高于秋水仙碱组,差异有统计学意义(P<0.01)。结论吲哚美辛栓可迅速缓解急性痛风性关节炎患者的疼痛和迅速降低体温,且安全性好。     

吲哚美辛栓致严重不良反应一例

1 临床资料患男．62岁，因小便困难伴尿路刺激症状10余年，加重2周，经诊断以良性前列腺增生、附睾炎收治入院。入院时神志清，精神可，呼吸平稳。体温37．2℃．心率79次／min，呼吸20次／min．BP 140/95 mmHg(18．7／12．7kPa)．全身肌肉无触痛，腹部无压痛，自述无过敏史．无阿司匹林用药史。住院第3天．成功行尿道经前列腺汽化切割术，术后患尿路刺激疼痛。遵医嘱给予吲哚美辛(消炎痛)栓(100mg／枚，上海医药工业研究院实验药厂，批号0408l3)1枚肛塞．约60min后患出现呼吸急促、胸闷、出汗、心慌，继而发生短暂性意识丧失。     

吲哚美辛栓引起的全身性过敏反应

吲哚美辛栓具有解热、镇痛及非特异性抗炎作用。其最常见的不良反应是胃刺激和头痛。过敏反应较为罕见。吲哚美辛栓可避免胃肠道刺激,使用方便、副作用少。但在我院对症治疗的同时,就2000年7～8月份在妇产科出现吲哚美辛栓致全身性过敏反应的人数达5人以上,其中最为严重的1例现报道如下。     

吲哚美辛栓致不良反应1例

患者,女,58岁,体质消瘦,营养中度,体检发现右肾积水,于2010年8月11日入院,体温（T）36．5℃,心率（P）80次／min,呼吸（R）20次／min,血压（BP）60／90mmHg（1mmHg=0．133kPa）,无发热、尿急、尿痛、尿频、无肉眼血尿。饮食二便正常,既往史一般状况良好,无药物过敏史。     

美施康定联合吲哚美辛栓治疗晚期癌痛患者疗效评估

目的评估美施康定联合吲哚美辛栓与单一大剂量应用美施康定临床的疗效。方法晚期癌痛患者140例随机分为2组:对照组75例和观察组65例。观察组给予小剂量美施康定口服及吲哚美辛栓纳肛,对照组仅给予美施康定口服。观察2组的有效率及不良反应发生率。结果对照组有效66例,观察组有效58例,差异无统计学意义(P>0.05)。2组不良反应发生率:头晕、恶心呕吐、便秘,差异均有统计学意义(P<0.05)。结论小剂量美施康定联合吲哚美辛栓治疗晚期癌痛患者疗效与单一大剂量应用美施康定相比副反应更小,且更经济,且止痛效果无明显差别。     

吲哚美辛栓用于原发性痛经的疗效观察

目的：观察吲哚美辛栓治疗原发性痛经的疗效。方法：选择100例在本院妇科门诊治疗痛经的学生、用吲哚美辛栓置于患者肛门内,用药30min后观察疗效。结果：85例患者30min后痛经症状消失,4例症状减轻,1例无效,有效率为99％。结论：吲哚美辛栓肛门内用药经济方便,见效快,可用于治疗原发性痛经。     

吲哚美辛保留灌肠治疗小儿发热1 986例次

1　临床资料1 1　一般资料　 1986例次均系我院 1996～ 2 0 0 2年门诊及住院患儿 ,男 10 0 1例次 ,女 985例次。年龄 :2～ 2 8d 5 9例次 ,～ 1岁 792例次 ,～ 3岁 72 1例次 ,～ 7岁 4 14例次。用药前患儿体温均在 38 5℃以上 (新生儿体温均超过 38 7℃ )。所患疾病 :上呼吸道感染 112 1例次 ,其他病毒或细菌感染性疾病 (包括支气管炎、肺炎、病毒性脑炎、化脓性脑膜炎、败血症、细菌性痢疾等 ) 74 2例次 ,非感染性疾病 12 3例次。1 2　治疗方法　吲哚美辛用量为 1 0mg·kg-1·次-1,研碎后加生理盐水 5～ 10ml保留灌肠。1 3　结果　 192 4例…     

吲哚美辛栓的溶出度比较研究

目的通过溶出度实验评估不同栓剂的质量差异。方法采用《中国药典》的溶出度测定法第二法（附录XC中第二法）,以磷酸盐缓冲液（pH7．4）900mL为溶出介质,转速为75r／min,照紫外检测分光光度法在320nm波长处测定吸光度。结果改良基质制备的栓剂（自研产品1）与市售产品4溶出较快,60min时溶出度大于70％,自研产品1经长期稳定性考察,其溶出度无明显变化。结论改良基质制备的栓剂（自研产品1）外观光滑,硬度适宜,溶出度及稳定性良好,符合各国药典要求。     

布洛芬和对乙酰氨基酚治疗小儿感染性发热疗效比较

目的：了解布洛芬混悬液（美林）治疗儿童感染性发热的有效性和安全性,为临床选择1：1服退热药提供参考。方法：116例急性上呼吸道感染伴发热的患儿随机分为两组。治疗组72例,对照组44例,分别给予布洛芬（美林）和对乙酰氨基酚（泰诺林）治疗。结果：两组在服药后2h内退热的有效率分别为98．6％、95．5％,差异无统计学意义（P〉0．05）,但对照纽从服药自3～4h开始体温呈现回升趋势,而治疗组在服药后能雏持7～8h体温不回升,显效率分别为95．8％、70．5％,差异有统计学意义（P〈0．01）。结论：布洛芬混悬液退热作用强,维持时间久。     

双氯芬酸钠栓与对乙酰氨基酚栓治疗小儿急性发热对比分析

目的:探讨双氯芬酸钠栓剂和对乙酰氨基酚栓在儿科临床的退热效果和安全性,为临床选择退热药提供参考。方法:100例急性发热患儿随机分为观察组和对照组,观察组予双氯芬酸钠栓0.5 mg/(kg.次),肛门给药;对照组予对乙酰氨基酚栓10mg/(kg.次),肛门给药。结果:观察组的起效时间[(41.63±3.71)min]短于对照组[(55.19±5.11)min],维持正常体温的时间[(7.31±1.62)h]长于对照组[(6.57±1.73)h],两组比较差异均有统计学意义(P<0.01)。结论:双氯芬酸钠栓对高热患儿具有退热作用快,维持时间长,使用方便、安全,无明显胃肠道反应等特点。     

布洛芬和对乙酰氨基酚治疗小儿感染性发热临床疗效比较

目的:探讨布洛芬和扑热息痛在儿科临床的退热效果和安全性,为临床选择口服退热药物提供参考。方法: 108例感染性发热患儿随机分为布洛芬组和扑热息痛组,布洛芬组予布洛芬8mg/(kg·次)顿服;扑热息痛组予对乙酰氨基酚15mg/(kg·次)顿服。结果:布洛芬组60min体温下降幅度明显大于对乙酰氨基酚组(t= 2. 75,P< 0. 01),最大作用时间及退热持续时间均有显著性差异(t= 3. 23、5. 01,P均< 0. 01)。结论:布洛芬和对乙酰氨基酚退热效果确切,但布洛芬退热作用更强更快,体温下降更明显和维持时间更长,可作为儿科临床医师第一线的退热药。     

布洛芬、赖氨匹林和对乙酰氨基酚治疗小儿发热的疗效比较

目的：比较布洛芬混悬液（美林）、注射用赖氨匹林、对乙酰氨基酚栓对急性呼吸道感染伴高热患儿的退热效果。方法：选择有急性呼吸道感染伴有发热症状的患儿170例,随机分为三组,分别给予布洛芬混悬液f美林）、赖氨匹林注射液、对乙酰氨基酚栓治疗。结果：在1h内,赖氨匹林注射液退热速度最快,布洛芬混悬液次之,对乙酰氨基酚栓最慢,三者两两间有非常显著性差异（S〉S0.01）。在1～2h,布洛芬混悬液退热速度最快,其次是对乙酰氨基酚栓,赖氨匹林注射液的退热速度最慢（P〈0．01）。在2～3h,布洛芬混悬液与赖氨匹林注射液的退热速度无显著性差异（P〉0．05）,两者快于对乙酰氨基酚栓（P〈0．01）,对乙酰氨基酚栓组的体温呈回升趋势。在3～8h,布洛芬混悬液仍有退热效果,与赖氨匹林注射液和对乙酰氨基酚栓有非常显著性差异（P〈0．01）,赖氨匹林注射液组和对乙酰氨基酚栓组的体温均呈现回升。布洛芬混悬液能在2h内使患儿体温降至正常,并能维持8h。赖氨匹林注射液能在2h内使患儿体温降至正常,并能维持3h,3-6h后体温呈回升趋势。对乙酰氨基酚栓给药后2～3h体温呈回升趋势。布洛芬混悬液、赖氨匹林注射液的总有效率均为100．0％,对乙酰氨基酚栓的总有效率为94．0％。布洛芬混悬液退热的显效率为90．0％．赖氨匹林注射液为92．0％,对乙酰氨基酚栓为36．0％：布洛芬混悬液和赖氨匹林注射液的疗效比较无显著性差异（P〉0．05）,两者优于对乙酰氨基酚栓（P〈0．01）。结论：布洛芬混悬液和赖氨匹林注射液的退热作用强,布洛芬混悬液的维持时间长,赖氨匹林注射液的维持时间中等,对乙酰氨基酚栓的退热作用较弱,维持时间短。     

Evaluation of ibuprofen versus aspirin and paracetamol on efficacy and comfort in children with fever

Objective: We compared efficacy and impact on the comfort of ibuprofen (7.5 mg/kg per dose), aspirin (10 mg/kg/dose) and paracetamol (10 mg/kg per dose) on children with fever aged 6–24 months in an open, randomised study with three parallel groups. Methods: The main criterion for efficacy was area under the curve (AUC) of percentage temperature reduction. Comfort was assessed on scores depending on general behaviour and degree of relief. General behaviour was assessed on a verbal scale and on a visual analogue scale (VAS) and the degree of relief was assessed in relation to baseline on a verbal scale. Results: The efficacy of ibuprofen was better than that of aspirin or paracetamol. In spite of more adverse events, the comfort scores were significantly in favour of ibuprofen 6 h after the first dose of treatment. Received: 29 March 1996 / Accepted in revised form: 2 August 1996     

Ibuprofen versus paracetamol in pediatric fever: objective and subjective findings from a randomized,blinded study

ABSTRACT

Objective: The main objective of this study was to compare the single-dose efficacy of 15?mg/kg paracetamol (acetaminophen) versus 10?mg/kg ibuprofen in a general practice setting.

Methods: Children from the age of 3 months to 12 years with a fever of non-serious origin were randomized to receive either ibuprofen or paracetamol. The first dose was given double-blind, using a double-dummy technique. Tympanic temperature was measured at baseline and over the following 8 hours. The second and subsequent doses were administered open-label for up to 3 days by parents at home. At the end of the double-blind and the open-label periods, parents were asked to subjectively rate the efficacy of the product and state whether they would treat their child with the product again. The primary endpoint of the study was the area under the temperature reduction curve expressed as an absolute difference from baseline, from 0 to 6 hours (AUC_0–6).Secondary efficacy endpoints included a variety of objective and subjective measures.

Results: No statistically significant differences in the primary endpoint or any of the objective secondary endpoints were observed. Both agents were equally well tolerated. Compared with parents in the paracetamol group, significantly more parents in the ibuprofen group rated the drug as very efficacious, and reported that they would use the drug again in both the double-blind and open-label phases of the study.

Conclusions: Ibuprofen at a dose of 10?mg/kg and paracetamol at a dose of 15?mg/kg have equivalent efficacy and tolerability; parental opinion in favor of ibuprofen could be explained by additional benefits of ibuprofen that were not measured in this trial and helped allay their anxiety over the treatment of their child.     

高效液相色谱法测定对乙酰氨基酚口服溶液的含量

目的 　建立高效液相色谱法测定对乙酰氨基酚口服溶液中对乙酰氨基酚的含量 ,方法 　 Alltech-C1 8柱为固定相 ,甲醇 -水 (2 0∶ 80 )为流动相 ,检测波长 :2 44 mm,用外标法定量。 结果 　线性范围 :对乙酰氨基酚在 12 μg· m L- 1～ 12 0 μg· m L- 1浓度范围呈良好线性关系。 A=-13 5 0 2 .760 8+ 783 0 4.5 789C,r=0 .999。测得 3批的回收率分别为 98.7%、98.5 %、97.8% ,RSD分别为 0 .5 9%、0 .64 %、0 .42 %。结论 　本法简便快捷、结果准确 ,适用于对乙酰氨基酚口服溶液的含量测定。     

RP-HPLC法测定复方氨酚烷胺胶囊中对乙酰氨基酚和咖啡因含量

目的 建立RP-HPLC法测定复方氨酚烷胺胶囊中对乙酰氨基酚和咖啡因的含量.方法 采用Hypersil C18柱,以甲醇-水(40∶60)为流动相,检测波长216 nm,流速为1.0ml·min-1.结果 对乙酰氨基酚在101.5～1522.5μg·mL-1的浓度范围内呈良好的线性关系(r=0.9999),平均回收率100.0%,咖啡因在9.36～47.34μg·mL-1的浓度范围内呈良好的线性关系(r=1),平均回收率99.7%.结论 本方法简便快速,结果正确、可靠、重复性好.     

Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever

ABSTRACT

Objective: The main aim of this review was to compare the tolerability and safety between ibuprofen and paracetamol when used as anti-pyretic and analgesic agents in children up to 18 years of age.

Methods: MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), The Cochrane Library (2007, Issue 3), ACP Journal Club (1991 to November 2007) and Pascal (1987 to November 2007) were searched for randomised controlled trails (RCTs) (comparing ibuprofen and/or paracetamol with placebo), controlled observational studies and large case series comprised more than 1000 participants.

Main outcome measures: Adverse events (AEs) requiring discontinuation of medication; systemic reactions related to ibuprofen or paracetamol; serious AEs that are fatal, life-threatening or require hospitalisation; and serious AEs not requiring hospitalisation.

Results: A total of 24 RCTs examined either ibuprofen and/or paracetamol versus placebo for AE data. Twelve other studies meeting our criteria were also included for AE data. Meta-analysis of systemic reactions demonstrated that tolerability and safety of ibuprofen was similar to placebo, as was paracetamol: ibuprofen versus placebo relative risk (RR) 1.39 (95% CI: 0.92, 2.10); paracetamol versus placebo RR 1.57 (95% CI 0.74, 3.33). A total of 2937 systemic AEs occurred in 21?305 patients taking ibuprofen compared with 1466 systemic AEs in 11?164 patients taking paracetamol: RR 1.03 (95% CI 0.98, 1.10). There was no significant difference between the two groups. Narrative analysis of AE data identified conflicting evidence regarding hepatic injury with paracetamol and group A streptococcal infections with ibuprofen or paracetamol treatment.

Conclusions: Ibuprofen, paracetamol and placebo have similar tolerability and safety profiles in terms of gastrointestinal symptoms, asthma and renal adverse effects. While the study data investigated here may not reflect over-the-counter use, these results are still relevant in the context of any safety concerns relating to general ibuprofen or paracetamol treatment in children.