醋氯芬酸治疗类风湿性关节炎和骨关节炎的临床观察

Clinical observation of aceclofenac in treatment of rheumatoid arthritis(RA) and osteoarthritis(OA)

目的观察醋氯芬酸治疗类风湿性关节炎(RA)和骨关节炎(OA)的疗效和安全性。方法将126名患者随机分为治疗组64例,其中RA36例,OA28例,每天早晚各服醋氯芬酸0.1g;对照组62例,其中RA35例,OA27例,每天早晚各服布洛芬缓释胶囊0.3g。疗程均为4周。分别观察治疗前后临床指标和炎性实验的变化以及不良反应的发生。结果醋氯芬酸和布洛芬治疗RA4周后,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,醋氯芬酸的总有效率为77.8%。两者治疗OA4周后,膝关节活动痛、15min行走时间、日常活动能力及患者综合评估均有显著改善,醋氯芬酸的总有效率为71.4%。醋氯芬酸对RA和OA的疗效与布洛芬相比无显著性差异。醋氯芬酸以胃肠道反应为主的不良反应发生率为14.3%,低于布洛芬(25.9%)。结论从临床角度而言醋氯芬酸对RA和OA均为安全、有效的治疗药物。

[Objective] To evaluate the efficacy and safety of aceclofenac in treatment of RA and OA. [Methods] 126 patients with RA and OA were divided into active ann （36RA and 280A） and control ann （35RA and 270A） in a randomized way. Patients in the active ann were treated with aceclofenac enteric-coated capsules in twice daily dose of 100 nag for 4 weeks, and patients in the control arm were treated with ibuprofen SR capsules in twice daily dose of 300 mg for 4 weeks. [Result] After 4 weeks treatment, all parameters （VSA value, pain, Ritehie joint index, grip strength of hands, and morning stiffness） in patients with RA and OA were significantly improved for both agents （aeeelofenae and ibuprofen）, and there were no significant difference between the efficacy of the two agents. The incidence of GI side effects was 14.3% the active ann for and 25.9% for the control arm （P 〈0.05）. [Conclusion] Aceclofenae is an effective agent for treatment of RA and OA with fewer GI side effect in comparison with traditional NSAIDs.