青藤碱关节腔内注射治疗急性痛风性膝关节炎的临床观察

Clinical observation of treating patients with acute knee gouty arthritis by intra-articularly injecting sinomenine

目的:观察青藤碱关节腔内注射治疗急性痛风性膝关节炎的临床疗效。方法:纳入确诊为急性痛风性膝关节炎的患者共57例,给予复方青藤碱注射液(35mg)关节腔内注射治疗(1次/日,每次2.4mL,共计5次)。采用VAS评分法(Visualanaloguescale,视觉模拟评分法)评价治疗前后的疼痛分级;观察青藤碱局部注射的不良反应;随访调查痛风性关节炎复发情况。结果:VAS评分结果显示,青藤碱注射治疗总有效率为94.7%,优良率为73.7%。治疗期间无患者发生血管误入;青藤碱不良反应发生率为16%,均表现为注射关节局部的轻微皮肤不良反应。随访结果显示,3月内痛风性关节炎的复发率为3.5%,6月内的复发率为12.3%。结论:急性痛风性膝关节炎确诊必须依据患者病史,症状、体征及辅助检查。青藤碱关节腔内注射可有效缓解急性期疼痛,且操作简便,不良反应发生率低;其长期疗效有待进一步研究。VAS评分具有简便、易被患者接受的特点,可应用于临床关节疼痛、止痛疗效的评价分级。

Objective：To observe the effect of intra-articularly injecting sinomenine on patients with acute knee gouty arthritis. Methods： 57 patients who had been diagnosed as acute knee gouty arthritis were injected sinomenine by intra-articular route in which the VAS （visual analogue scale） score was used to assess the severity of pain,the side effect of sinomenine were monitored and the recurrence of arthritis was recorded. Results： The total effective rate of intra-articularly injecting sinomenine was 94.7%, and excellent rate was 73.7% by VAS score in which no patients had a complication of the injection.16% of the patient occurred side effects of sinomenine such as skin sensibility which was easily manageable. After 3 months of follow-up, the recurrence rate was 3.5%, while it was 12.3% after 6 months.Conclusion： The diagnosis of acute knee gouty arthritis should be based on patients＂ history of the disease, symptoms, chnical signs and laboratory examinations. Sinomenine can effectively reduce the pain though a procedure of the intra-articular injection. The side effect of this treatment is minor and manageable, while its long term effects on recurrence should be further investigated. The VAS score have advantages of quickness and acceptability by patients, which is recommended for the assessment of pain caused by gouty arthritis.