双醋瑞因胶囊联合柳氮磺胺吡啶肠溶片与右旋布洛芬胶囊治疗强直性脊柱炎

Study on the curative effects of diacerein capsules combined with sulfasalazine enteric-coated tablets and dextral ibuprofen capsules in the treatment of ankylosing spondylitis

目的:观察双醋瑞因胶囊联合柳氮磺胺吡啶肠溶片与右旋布洛芬胶囊治疗强直性脊柱炎的临床疗效及安全性。方法:将60例强直性脊柱炎患者随机分为2组,治疗组(40例)采用双醋瑞因胶囊联合柳氮磺胺吡啶肠溶片与右旋布洛芬胶囊治疗,对照组(20例)采用柳氮磺胺吡啶肠溶片与右旋布洛芬胶囊治疗。3个疗程后比较2组患者血沉下降幅度、C反应蛋白下降幅度、关节痛和腰背部疼痛评分变化情况及总体疗效。结果:①治疗组血沉下降幅度大于对照组(t=2.509,P=0.017);治疗组与对照组C反应蛋白下降幅度比较,差异无统计学意义(t=-0.078,P=0.938);治疗组关节痛和腰背部疼痛评分下降幅度大于对照组(t=-2.686,P=0.010)。②治疗组临床疗效优于对照组(Z=-2.106,P=0.035)。③治疗组不良反应主要表现为轻度腹泻3例,上腹部疼痛2例,白细胞数升高2例,白细胞数降低1例,恶心、呕吐1例;对照组不良反应主要表现为腹胀2例,恶心1例,肝功能轻度异常1例。2组患者均未出现尿常规及肾功能明显异常。结论:采用双醋瑞因胶囊联合柳氮磺胺吡啶肠溶片与右旋布洛芬胶囊治疗AS,能够降低急性期反应物指标,缓解关节及腰背部疼痛,疗效确切,且不良反应轻微,值得临床推广引用。

Objective：To observe the clinical curative effects and safety of diacerein capsules combined with sulfasalazine enteric-coa- ted tablets and dextral ibuprofen capsules in the treatment of ankylosing spondylitis （AS）. Methods：Sixty AS patients were randomly divided into 2 groups. Forty cases in treatment group were administrated with diacereiu capsules combined with sulfasalazine enteric-coated tablets and dextral ibuprofen capsules, while the others in the control group were administrated with sulfasalazine enteric-coated tablets and dextral ibuprofen capsules. The following indexes as erythrocyte sedimentation rate （ESR） , c-reactive protein（CRP） , visual analogue scores （VAS） of arthralgia and lumbus-back pain and the overall curative effects of the patients were compared between the 2 groups after three courses of treatment. Results： （1）The decreasing degree of ESR in treatment group was superior to that in control group （ t = 2. 509, P = 0. 017）. There was no statistical difference between treatment group and control group in the decreasing degree of CRP （ t = - 0. 078, P = 0,938 ）. The decreasing degree of VAS of arthralgia and lumbar-back pain in treatment group was superior to that in control group （ t = - 2. 686,P = 0. 010）. （2）The clinical curative effect of treatment group was better than that of control group （ Z = - 2. 106,P = 0. 035 ）. （3） The adverse reactions in treatment group were mainly reflected as 3 cases with mild diarrhea, 2 cases with upper abdominal pain, 2 cases with increased number of white blood cells, 1 case with decreased number of white blood cells and 1 case with nausea and vomiting. And the adverse reactions in control group were mainly reflected as 2 cases with abdominal distension, 1 case with nausea and 1 case with mild abnormalities in hepatic function. No obvious abnormities of uric convention and renal function were found in both groups. Concluslon：The therapy of diacerein capsules combined with sulfasalazine enteric-coated tablets and dextral ibuprofen capsules can reduce acute phase reactant index and relieve the pain in joint and lumbus-back when it is used in the treatment of AS, furthermore, it has certain curative effects with mild adverse reactions, and it is worthy of popularizing in clinic.