【摘要】 目的观察双氯芬酸钠联合苯溴马隆、甲泼尼龙对痛风性关节炎（GA）患者关节液及血液相关指标的影响。方法将72例GA患者随机分为对照组和试验组,每组36例。对照组给予双氯芬酸钠,每次0. 1 g,每天2次,口服,苯溴马隆,每次50 mg,每天2次,口服;试验组在对照组的基础上给予甲泼尼龙,每次4 mg,每天1次,口服。2组均连续治疗1个月。比较2组患者的临床疗效、疼痛缓解时间、关节症状评分、血液学指标、关节液炎性因子指标及药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为97. 22%,77. 78%,差异有统计学意义（P <0. 05）。试验组的Ⅱ度以上缓解时间和Ⅳ度缓解时间分别为（6. 18±2. 07）和（26. 06±11. 63） h,对照组分别为（10. 36±5. 49）和（35. 27±14. 59） h,差异有统计学意义（P <0. 05）。治疗后,试验组的关节疼痛、关节压痛、关节肿胀评分、血尿酸、红细胞沉降率（ESR）、肿瘤坏死因子-α（TNF-α）、前列腺素E2（PGE2）、白细胞介素-6（IL-6）及白细胞介素^-1(IL^-1)水平分别为（0. 95±0. 27）分,（0. 91±0. 25）分,（0. 69±0. 21）分,（311. 19±19. 22）μmmol·L^-1,（22. 37±4. 48） mm·h^-1,（30. 09±8. 25）ng·L^-1,（4. 38±2. 63） ng·L^-1,（16. 92±7. 93） ng·L^-1,（20. 72±8. 31）ng·L^-1,对照组分别为（1. 49±0. 39）分,（1. 52±0. 33）分,（1. 06±0. 37）分,（392. 24±28. 35）μmmol·L^-1,（35. 91±5. 51） mm·h^-1,（36. 27±10. 82）ng·L^-1,（7. 16±2. 25） ng·L^-1,（20. 85±8. 17） ng·L^-1,（26. 36±10. 59）ng·L^-1,差异均有统计学意义（均P <0. 05）。2组药物不良反应发生率比较,差异无统计学意义（P> 0. 05）。结论双氯芬酸钠、苯溴马隆和甲泼尼龙联用对GA患者具有良好的治疗效果,患者的关节液及血液相关指标均得以显著改善。更多还原

【Abstract】 Objective To explore the effects of diclofenac sodium combined with benzbromarone and methylprednisolone on the related indexes of joint fluid and blood in patients with gouty arthritis（ GA）. Methods Seventy-two patients with GA were randomly divided into control group and treatment group,with 36 cases in each group. Control group was given diclofenac sodium 0. 1 g,twice a day,oral,and benzbromarone 50 mg,twice a day,oral. Treatment group was given methylprednisolone 4 mg,once a day,oral. Patients in two groups were treated continuously for one month. The clinical efficacy,pain relief time,score of joint symptom blood index and inflammatory factor index of joint fluid were detected between the two groups. Results After treatment,the total effective rates in treatment group and control group were 97. 22%,77. 78%,with significant difference（ P < 0. 05）. The remission time of degree Ⅱ or above and degree Ⅳ in treatment group were（ 6. 18 ± 2. 07） h and（ 26. 06 ± 11. 63） h,had significant difference with those in control group,which were（ 10. 36 ± 5. 49） and（ 35. 27 ± 14. 59） h（ P < 0. 05）. After treatment,the joint pain,joint tenderness,joint swelling score,blood uric acid,erythrocyte sedimentation rate（ ESR）,levels of tumor necrosis factor-α（ TNF-α）,prostaglandin E2（ PGE2）,interleukin-6（ IL-6） and interleukin^-1( IL^-1) in treatment group were 0. 95 ± 0. 27,0. 91 ± 0. 25,0. 69 ± 0. 21,（ 311. 19 ± 19. 22） μmmol·L^-1,（ 22. 37 ± 4. 48） mm·h^-1,（ 30. 09 ± 8. 25） ng·L^-1,（ 4. 38 ± 2. 63） ng·L^-1,（ 16. 92 ± 7. 93） ng·L^-1,（ 20. 72 ± 8. 31） ng·L^-1,all had significant difference with those in control group, which were 1. 49 ± 0. 39, 1. 52 ± 0. 33, 1. 06 ± 0. 37,（ 392. 24 ± 28. 35） mmol·L^-1,（ 35. 91 ± 5. 51） mm·h^-1,（ 36. 27 ± 10. 82） ng·L^-1,（ 7. 16 ± 2. 25） ng·L^-1,（ 20. 85 ± 8. 17） ng·L^-1,（ 26. 36 ± 10. 59） ng·L^-1,all with significant difference（ all P < 0. 05）. There was no significant difference in the incidence of adverse drug reactions between the two groups（ P > 0. 05）.Conclusion The combination of diclofenac sodium,benzbromarone and low dose methylprednisolone has a good therapeutic effect on patients with GA. The related indexes of joint fluid and blood of patients can be significantly improved. It can also promote the reduction of serum uric acid concentration and effectively improve the clinical symptoms.更多还原