不同剂量秋水仙碱治疗痛风性关节炎患者的临床效果比较

目的 探讨不同剂量秋水仙碱治疗痛风性关节炎的临床效果。 方法 选择温州市中西医结合医院2015年3月—2016年6月收治的98例患者随机分为A组(33例)、B组(33例)和对照组(32例)。对照组给予美洛昔康治疗，A组在对照组的基础上给予小剂量秋水仙碱治疗，B组在对照组的基础上给予常规剂量秋水仙碱治疗。观察比较3组临床疗效，疼痛缓解时间、发作次数、复发次数，血尿酸、红细胞沉降率、C反应蛋白水平及不良反应。 结果 A组临床有效率为96.97%，B组为90.91%，二者均显著高于对照组的78.13%(χ2=10.664，P=0.005)；且A组与对照组间总有效率差异存在统计学意义(Z=-3.631，P<0.001)。3组关节炎疼痛缓解时间、发作次数及复发次数比较差异均存在统计学意义(F=9.281，P<0.001；F=4.372，P=0.016；F=6.714，P=0.002)；A、B两组均显著低于对照组(P<0.05)。治疗后，3组红细胞沉降率及C反应蛋白水平均显著下降(P<0.05)，A、B两组显著低于对照组(P<0.05)；3组间血尿酸水平差异未见统计学意义(P>0.05)。A组不良反应发生率为21.21%，对照组为12.50%，二者均显著低于B组的54.55%(χ2=15.461，P<0.001)；且A、B两组，B组与对照组间不良反应发生率差异存在统计学意义(χ2=7.791，P=0.005；χ2=12.827，P<0.001)。 结论 小剂量秋水仙碱治疗痛风性关节炎临床效果显著，可有效缩短疼痛缓解时间及复发次数，降低红细胞沉降率，安全性高，值得推广。 

Clinical effect of the different dosage of colchicine on 98 cases of gouty arthritis

Objective To investigate the clinical effect of the different dosage of colchicine on gouty arthritis. Methods Ninety-eight patients admitted to our hospital from March,2015 to June,2016 were randomly divided into group A(n=33),group B(n=33) and control group(n=32).The control group was treated by meloxicam,the group A was treated with a small dose of colchicine based on the control group,and the group B was treated with the conventional dose of colchicine based on the control group.It compared the clinical efficacy,the time of pain relief,the frequency of episodes and recurrence,the level of serum uric acid,erythrocyte sedimentation rate and C reactive protein,and adverse reaction. Results The clinical effective rate was 96.97% in group A,90.91% in group B,which were significantly higher than that of 78.13% in the control group(χ2=10.664,P=0.005).And there was significant difference between the group A and the control group (Z=-3.631,P<0.001).There were statistically significant differences in the time of pain relief,the frequency of episodes and recurrence among three groups(F=9.281,P<0.001;F=4.372,P=0.016;F=6.714,P=0.002).Group A and group B were significantly lower than the control group(P<0.05).After treatment,the level of erythrocyte sedimentation rate and C reactive protein were significantly decreased among three groups (P<0.05),and they were significantly lower in group A and group B than the control group (P<0.05).There was no significant difference in the level of serum uric acid among three groups (P>0.05).The adverse reaction rate of group A was 21.21%,and 12.50% of control group,which were significantly lower than that of 54.55% in the group B(χ2=15.461,P<0.001).And there were significant difference between the group A and B,the group B and the control group (χ2=7.791,P=0.005;χ2=12.827,P<0.001). Conclusion It has a significant clinical efficacy of a small dose of colchicine in the treatment of gouty arthritis.It can effectively shorten the time of pain relief and the frequency of recurrence,reduce the level of erythrocyte sedimentation rate,and high safety,which is worthy of popularization and application.