摘要
目的探讨应用小剂量秋水仙碱联合美洛昔康治疗难治性痛风性关节炎(GA)的效果。方法队列研究。抽取2018年1月至2024年1月河南中医药大学人民医院收治的难治性GA患者60例, 按随机数字表法分为小剂量组(美洛昔康联合小剂量秋水仙碱治疗)与大剂量组(美洛昔康联合大剂量秋水仙碱治疗), 每组30例。比较两组治疗效果、疼痛与肿胀程度评分、血生化指标[血尿酸(BUA)、红细胞沉降率(ESP)、C反应蛋白(CRP)、总胆固醇(TC)、三酰甘油(TG)、碱性磷酸酶(AKP)]及不良反应发生情况。结果大剂量组总有效率(93.33%, 28/30)高于小剂量组(86.67%, 26/30), 但差异未见统计学意义(P>0.05)。治疗后, 两组BUA、ESP、CRP、TC、TG、AKP水平均低于治疗前(P均<0.05), 但两组比较差异未见统计学意义(P>0.05)。治疗1、2、3、5、7 d后, 两组疼痛与肿胀程度评分均低于治疗前(P均<0.05), 但两组间比较差异未见统计学意义(P>0.05)。小剂量组不良反应发生率(46.67%, 14/30)低于大剂量组(10.00%, 3/30), P<0.05。结论难治性GA予以小剂量秋水仙碱联合美洛昔康治疗, 在提高临床疗效、改善血生化指标、减轻疼痛与肿胀程度等方面的效果和大剂量秋水仙碱联合美洛昔康治疗基本相似, 但小剂量秋水仙碱可以更好地减轻肝、肾功能损伤及胃肠道反应等不良反应。
ObjectiveTo investigate the effect of low-dose colchicine combined with meloxicam in the treatment of refractory gouty arthritis(GA).MethodsThe cohort study was conducted on 60 patients with refractory GA admitted to the People’s Hospital of Henan University of Chinese Medicine from January 2018 to January 2024.And they were divided into the low-dose group(treated with meloxicam combined with low-dose colchicine)and the high-dose group(treated with meloxicam combined with high-dose colchicine)according to the random number table method,with 30 cases in each group.The treatment effect,pain and swelling score,blood biochemical indexes including blood uric acid(BUA),erythrocyte sedimentation rate(ESP),C-reactive protein(CRP),total cholesterol(TC),triglyceride(TG)and alkaline phosphatase(AKP),and adverse reactions were compared between the two groups.ResultsThe total effective rate of the high-dose group(93.33%,28/30)was higher than that of the low-dose group(86.67%,26/30),but the difference was not statistically significant(P>0.05).After treatment,the levels of BUA,ESP,CRP,TC,TG and AKP in the two groups were lower than those before treatment(all P<0.05),but there was no significant difference between the high-dose group and the low-dose group(P>0.05).After 1,2,3,5 and 7 days of treatment,the scores of pain and swelling in the two groups were lower than those before treatment(all P<0.05),but there was no significant difference between the high-dose group and the low-dose group(P>0.05).The incidence of adverse reactions in the low-dose group(46.67%,14/30)was lower than that in the high-dose group(10.00%,3/30),P<0.05.ConclusionsThe effect of low-dose colchicine combined with meloxicam in the treatment of refractory GA is similar to that of high-dose colchicine combined with meloxicam in improving clinical efficacy,improving blood biochemical indicators,reducing pain and swelling;however,low-dose colchicine can better reduce liver and kidney function damage and gastrointestinal reactions.
作者
郇稳
赵怡冰
刘志队
王静
桂银莉
赵曼
李陶冉
韩丹
常琼洁
魏艳林
陈运转
Huan Wen;Zhao Yibing;Liu Zhidui;Wang Jing;Gui Yinli;Zhao Man;Li Taoran;Han Dan;Chang Qiongjie;Wei Yanlin;Chen Yunzhuan(Department of Rheumatology and Immunology,People’s Hospital of Henan University of Chinese Medicine,People’s Hospital of Zhengzhou,Zhengzhou 450003,China)
出处
《中国实用医刊》
2025年第13期84-87,共4页
Chinese Journal of Practical Medicine
基金
郑州市科技惠民计划项目(2022KJHM0006)。
作者简介
通信作者:陈运转,Email:huanwenzz@163.com。
