尼美舒利治疗类风湿关节炎和骨性关节炎的临床研究

目的：观察国产尼美舒利对类风湿关节炎（ＲＡ）和骨性关节炎（ＯＡ）的疗效和安全性。方法：选取ＲＡ患者５９ 例和ＯＡ患者４４ 例。ｐｏ 尼美舒利片１００ ｍｇ，ｂｉｄ；对照组ｐｏ 布洛芬缓释胶囊３００ｍｇ，ｂｉｄ。治疗时间为４ｗｋ。分别观察治疗前后临床指标和炎性实验指标的变化。结果：尼美舒利治疗ＲＡ４ｗｋ 后，疼痛程度、压痛关节数、关节压痛指数、关节肿胀指数、握力、晨僵时间、血沉均显著改善。对ＲＡ的总有效率为８３．３％ 。治疗ＯＡ４ｗｋ 后，膝关节活动痛、１５ｍ 行走时间、日常活动能力及病人综合评估均有显著改善。对ＯＡ的总有效率为７５．０％ 。其不良反应总发生率为１９．２％ ， 以胃肠道反应为常见（９．６％）。尼美舒利对ＲＡ和ＯＡ的疗效及不良反应的发生率与布洛芬相比均无显著性差异。结论：尼美舒利对ＲＡ和ＯＡ的疗效及不良反应的发生率均与布洛芬相当。

Therapeutic efficacy and safety of nimesulide in rheumatoid arthritis and osteoarthritis patients

OBJECTIVE: To test the efficacy and safety of nimesulide in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) of knee. METHODS: 59 RA patients and 44 OA patients as defined by the American College of Rheumatology criteria were treated with oral nimesulide tablet 100 mg twice daily or ibuprofen 300 mg sustained release capsule twice daily for four weeks. RESULTS: In patients with RA, VAS value, pain, Ritchie joint index, grip strength of hands, and morning stiffness improved significantly after treatment. In patients with OA of knee, overall pain, pain on movement, walking time, global efficacy and quality of life scores showed good levels of improvement compared with baseline. In 83.3% of RA patients and 75.0% of OA patients, nimesulide was effective. The frequent events reported were gastrointestinal disorders, occurring in 9.6% of nimesulide patients. The total incidence of adverse reactions was 19.2% in nimesulide patients. There were no significant differences in efficacy and safety between the treatment groups. CONCLUSION: The efficacy and safety of nimesulide are equivalent to those of ibuprofen.