小剂量秋水仙碱联合塞来昔布治疗质子泵抑制剂诱使有痛风病史的上消化道出血患者发生急性痛风性关节炎的疗效观察

Observation on Efficacy of Low Dose of Colchicine Combined with Celecoxib in Treatment of Proton Pump Inhibitors Inducing Acute Gouty Arthritis of Upper Gastrointestinal Hemorrhage Patients with Medical History of Gout

目的:探讨小剂量秋水仙碱联合塞来昔布治疗质子泵抑制剂诱使有痛风病史的上消化道出血患者发生急性痛风性关节炎的疗效及安全性。方法:80例使用质子泵抑制剂的有痛风病史的上消化道出血患者中,72例发生急性痛风性关节炎,发生率为90.00%。将72例患者按计算机随机分配法分为观察组和对照组,每组36例。观察组患者给予小剂量秋水仙碱片联合塞来昔布胶囊,对照组患者给予塞来昔布胶囊,比较两组患者的疗效、不良反应发生情况及空腹胃酸p H变化情况。结果:观察组患者的总有效率为91.67%(33/36),明显高于对照组的69.44%(25/36),差异有统计学意义(P<0.05);观察组患者的不良反应发生率为13.89%(5/36),对照组为19.44%(7/36),两组的差异无统计学意义(P>0.05);治疗12、24、48 h后,两组患者空腹胃酸p H较治疗前升高,且观察组患者明显高于对照组,差异均有统计学意义(P<0.05)。结论:质子泵抑制剂可诱使有痛风病史的上消化道出血患者发生急性痛风性关节炎,采用小剂量秋水仙碱联合塞来昔布的治疗效果较好,且安全性较高。

OBJECTIVE： To probe into the efficacy and safety of low dose of colchicine combined with celecoxib in treatment of proton pump inhibitors（ PPI） inducing acute gouty arthritis of upper gastrointestinal hemorrhage（ UGH）patients with medical history of gout. METHODS： Of 80 UGH patients with medical history of gout induced by PPI,72 cases were acute gouty arthritis,with the rate of 90. 00%. 72 patients were randomly assigned into observation group and control group by computer,with 36 cases in each group. The observation group was given low dose of Colchicine tablets combined with Celecoxib capsules,while the control group was treated with Celecoxib capsules only,the clinical efficacy,changes of incidence of adverse drug reactions and fasting gastric acid p H of two groups were compared. RESULTS： After treatment, the total effective rate of observation group（ 91. 67%, 33/36） was significantly higher than that of the control group（ 69. 44%,25/36）,with statistically significant difference（ P〈0. 05）; the incidence of adverse drug reactions of observation group was 13. 89%（ 5/36）,that of the control group was 19. 44%（ 7/36）,without statistically significant difference（ P〉0. 05）. 12 h,24 h,48 h after treatment,the fasting gastric acid p H of both groups were higher than before treatment,and the fasting gastric acid p H of observation group was higher than that of the control group,with statistically significant difference（ P〈0. 05）. CONCLUSIONS：PPIs can induce acute gouty arthritis in UGH patients with medical history of gout,the efficacy of low dose of colchicine combined with celecoxib is remarkable,with high safety.