依托考昔联合关节腔内注射皮质类固醇治疗急性痛风性关节炎的疗效观察

目的观察依托考昔联合关节腔内注射皮质类固醇治疗急性痛风性关节炎的临床疗效。方法按1985年Holmes急性痛风诊断标准纳入急性痛风性关节炎患者80例,随机分为依托考昔联合关节腔内注射皮质类固醇组(E组)和依托考昔组(C组),每组40例。E组:依托考昔60mg,每天1次,连续服用8天,并于就诊当天进行病变关节腔内注射1.5ml消炎镇痛液(配置方法:复方倍他米松3.5mg+2%利多卡因0.5ml+0.9%NaCl溶液0.5ml);C组:依托考昔120mg,每天1次,连续服用8天。观察各组患者治疗前及第1、2、3、5、8d用药后4小时的视觉模拟评分(VAS),治疗疗程结束后受累关节的压痛、肿胀、关节活动情况,并观察各组患者的不良反应(恶心、呕吐、腹痛或腹部不适、腹泻、心悸、胸闷、异常出血)情况。结果治疗前两组患者VAS评分比较,差异无统计学意义(P>0.05);第1天治疗后两组VAS评分比较,E组优于C组(P<0.05);其他时点两组VAS评分比较,差异无统计学意义(P>0.05)。治疗结束后关节的压痛、肿胀、关节活动等情况两组比较,差异无统计学意义(P>0.05)。治疗过程中发生恶心、呕吐及胸闷的情况,E组明显低于C组(P<0.05),其他不良反应两组比较,差异无统计学意义(P>0.05)。结论依托考昔联合关节腔内注射皮质类固醇治疗急性痛风性关节炎比单独使用依托考昔时起效时间更快,不良反应更少,但两者总体镇痛效果相当。

Clinical Observation on Etoricoxib Joint with Corticosteroid Hormone Injected into Articular Cavity to Treat Acute Gouty Arthritis

Objective To observe the clinical effect on etoricoxib joint with corticosteroid hormone injected into ar- ticular cavity to treat acute gouty arthritis. Methods 80 patients selected based on the diagnostic criteria of acute gout by Holmes in 1985 were randomly divided into two groups： Etoricoxib joint with Corticosteroid Hormone injected into artic- ular cavity（group E,n=40） ; Etoricoxib group （group C,n=40） Group E： Etoricoxib 60rag qd was administrated succes- sively for 8 days,andl. 5ml anti-inflammatory analgesic liquid （3.5mg compound betamethasone ＋ 0. 5ml 2 %lidocaine ＋ 0.5ml 0.9%NaC1 solution） was injected into the pathological articular cavity on the first day. Group C： Etoricoxib 120mg qd was administrated successively for 8d. The intensity of pain was observed by using Visual Analogue Scale （VAS） before treatment and 4h after administration on the 1st, 2nd, 3rd, 5th and 8th day. Meanwhile, pressing pain, swell, movement of the affected joint as well as patients＇ adverse effects （nausea, vomiting, stomachache, abdominal discomfort, diarrhea, palpitation, chest distress, abnormal bleeding） were observed after operation. Results There was no significant difference in the score of VAS of between group C and group E before treatment（P〉0. 05）. After the treatment of the first day, Group E was lower than Group C in comparison of the score of VAS（P 〈0. 05）while there was no significant difference in the score of VAS between the two groups at other testing time point （P〉0.05） ; and in terms of pressing pain, swell, movement of the affected joint （P〉0.05）. The occurrence of adverse effects like （nausea, vomiting and chest distress） was significantly lower in group E than that in group C （P〈0.05）. No significant differences were found in comparison of other adverse effects （P〉0. 05）. Conclusion Adoption of etoricoxib joint with Corticoste- roid Hormone injected into articular cavity to treat acute gouty arthritis is faster than sole administration of Etoricoxib in taking effect and with less adverse effects. But the two therapies have the same effect on analgesia.