不同剂量秋水仙碱对痛风急性发作患者疼痛与炎症的缓解作用比较

目的 比较不同剂量秋水仙碱对痛风急性发作患者疼痛与炎症的缓解作用，探讨秋水仙碱治疗该病的最佳剂量。 方法 筛选出台州市第一人民医院2019年1月—2020年1月收治的94例痛风急性发作患者，按照随机数字表法将其分为A组(47例)与B组(47例)，2组均予以常规治疗以及秋水仙碱治疗，A组秋水仙碱初始剂量为1 mg，随后每小时0.5 mg或每2小时1 mg，第1日最大剂量6 mg；B组秋水仙碱初始剂量为1 mg，随后0.5 mg/次，3次/d。对比其疗效、疼痛缓解情况(VAS评分、疼痛缓解时间)、炎症缓解情况(IL-1、IL-6、CRP)以及不良反应(消化道症状、血常规异常、血压异常、肝功能损伤)。 结果 B组的总有效率(89.4%)与A组(93.6%)相近(P>0.05)。B组治疗后的VAS评分(2.4±0.8分)低于A组(3.2±1.1分)，且疼痛缓解时间(26.1±9.7) h短于A组的(37.5±10.4) h，均P<0.05；B组治疗后血清IL-1、IL-6、CRP水平依次为:(18.2±3.7) pg/mL、(41.4±7.6) pg/mL、(6.3±2.0) mg/L，均低于A组的(26.4±4.5) pg/mL、(53.2±9.4) pg/mL、(9.4±2.6) mg/L (均P<0.05)。B组的不良反应发生率(17.0%)低于A组(36.2%)，P<0.05。 结论 秋水仙碱小剂量给药对痛风急性发作患者疼痛与炎症的缓解作用显著，临床疗效的总有效率与大剂量给药相当，且不良反应发生率明显降低，值得推广。 

Comparison of the relieving effects of different doses of colchicine on pain and inflammation in patients with acute attack of gout

Objective To compare the relieving effects of different doses of colchicine on pain and inflammation in patients with acute attack of gout, and to explore the best dose of colchicine in the treatment of gout. Methods A total of 94 patients with gout acute attack admitted to Taizhou First People' s Hospital from January 2019 to January 2020 were randomly divided into two groups:group A (47 cases) and group B (47 cases). Both groups were treated with routine therapy and colchicine. The initial dose of colchicine in group A was 1 mg, then 0.5 mg/h or 1 mg/h, and the maximum dose on the first day was 6 mg. The initial dose of colchicine in group B was 1 mg, then 0.5 mg/time, 3 times/d. The efficacy, pain relief (VAS score, pain relief time), and inflammation relief were compared (IL-1, IL-6, CRP) and adverse reactions (gastrointestinal symptoms, abnormal blood routine, abnormal blood pressure, liver function damage). Results The total effective rate of group B (89.4%) was similar to that of group A (93.6%), P>0.05. The VAS score in group B[(2.4±0.8) points] was lower than that in group A[(3.2±1.1) points], and the time of pain relief[(26.1±9.7)h] was shorter than that in group A[(37.5±10.4)h], all P<0.05. The IL-1, IL-6 and CRP in group B[(18.2±3.7)pg/mL, (41.4±7.6)pg/mL, and (6.3±2.0)mg/L] were lower than those in group A[(26.4±4.5)pg/mL, (53.2±9.4)pg/mL, and (9.4±2.6)mg/L], all P<0.05. The incidence of adverse reactions in group B (17.0%) was lower than that in group A (36.2%), P<0.05. Conclusion Colchicine can relieve the pain and inflammation of patients with gout acute attack in a small dose. The total effective rate of clinical effect is the same as that in a large dose, and the incidence of adverse reactions is significantly reduced, which is worth popularizing.