秋水仙碱治疗痛风性关节炎的疗效及对患者红细胞沉降率、C反应蛋白、尿酸水平的影响

Effect of colchicine in the treatment of elderly patients with gouty arthritis and its influence on ESR, CRP and UA

目的探讨秋水仙碱片辅助治疗痛风性关节炎患者临床疗效，并观察其对患者红细胞沉降率（ESR）、C反应蛋白（CRP）及尿酸（UA）的影响。方法将符合本次研究纳入标准的70例痛风性关节炎患者按照随机数字表法分为对照组与观察组，各35例。对照组采用塞来昔布胶囊0.2 g，每天2次治疗；观察组采用秋水仙碱片0.5 mg，每天3次；塞来昔布胶囊0.2 g，每天2次。于治疗前后分别采用视觉模拟评分法（VAS）评价两组患者关节疼痛程度，采用Likert量表评价两组患者治疗前后关节肿胀情况。记录两组患者疼痛缓解时间。分别于治疗前、后检测两组患者ESR、CRP及UA水平。统计两组临床效果及不良反应。结果观察组治疗后VAS评分为（2.04±0.52）分，明显低于对照组的（3.53±1.22）分（t＝6.64，P＝0.00）；观察组治疗后关节肿胀评分为（0.62±0.24）分，明显低于对照组的（1.21±0.33）分（t＝8.55，P＝0.00）；两组治疗后VAS评分及关节肿胀评分明显低于治疗前（P〈0.05）。观察组疼痛缓解时间为（1.36±0.47）d，明显短于对照组的（1.79±0.63）d（t＝3.23，P＝0.00）。观察组治疗后ESR、CRP及UA水平分别为（12.65±3.17）mm/h、（12.14±2.27）mg/L、（417.82±55.88）μmol/L，明显低于对照组的（14.77±4.22）mm/h、（14.69±3.16）mg/L、（458.93±62.74）μmol/L（t＝2.37、3.87、2.89，P＝0.02、0.00、0.00）；两组患者治疗后ESR、CRP及UA水平明显低于治疗前（均P〈0.05）。观察组治疗总有效率80.00%，明显高于对照组的57.14%（χ2＝7.55，P＝0.02）；观察组不良反应率8.57%，与对照组的5.71%差异无统计学意义（χ2＝0.21，P＝0.64）。结论秋水仙碱片辅助治疗痛风性关节炎可降低其ESR、CRP及UA水平，改善其疼痛及关节肿胀程度，且不会增加不良反应。

ObjectiveTo investigate the clinical efficacy of colchicine tablets in the treatment of patients with gouty arthritis, and to observe the effect of colchicine tablets on erythrocyte sedimentation rate（ESR）, C-reactive protein （CRP） and uric acid （UA）.MethodsFrom March 2016 to March 2017, 70 patients with gouty arthritis in our hospital were randomly divided into control group and observation group according to the random number table method.The control group was treated with celecoxib capsules 0.2g, 2 times a day.The observation group was treated with colchicine tablets 0.5mg three times daily, celecoxib capsules 0.2g, 2 times a day.The visual analogue scale （VAS） was used to evaluate the degree of joint pain in two groups.The Likert scale was used to evaluate the swelling of the two groups before and after treatment.The pain relief time was recorded in both two groups.The ESR, CRP and UA were measured before and after treatment.The clinical effects and adverse reactions in the two groups were analyzed.ResultsAfter treatment, the VAS score of the observation group was （2.04±0.52）points, which was significantly lower than （3.53±1.22）points of the control group（t=6.64, P=0.00）. The joint swelling score of observation group after treatment was （0.62±0.24） points, which was significantly lower than （1.21±0.33）points of the control group（t=8.55, P=0.00）. After treatment, the VAS score and joint swelling score in the two groups were significantly lower than those before treatment （all P〈0.05）. The pain relief time of the observation group was significantly shorter than that of the control group [（1.36±0.47）d vs.（1.79±0.63）d, t=3.23, P=0.00]. After treatment, the ESR, CRP and UA levels of the observation group were （12.65±3.17）mm/h, （12.14±2.27）mg/L, （417.82±55.88）μmol/L, respectively, which were significantly lower than those of the control group [（14.77±4.22）mm/h, （14.69±3.16）mg/L, （458.93±62.74）μmol/L, t=2.37, 3.87, 2.37, P=0.02, 0.00, 0.00]. After treatment, the ESR, CRP and UA levels of the two groups were significantly lower than those before treatment （all P〈0.05）. The total effective rate of the observation group was 80.00%, which was obviously higher than 57.14% of the control group（χ2=7.55, P=0.02）. The incidence rate of adverse reaction of the observation group was 8.57%, which of the control group was 5.71%, the difference was not statistically significant （χ2=0.21, P=0.64）.ConclusionColchicine tablets combined with celecoxib capsules in the treatment of patients with gouty arthritis can reduce ESR, CRP and UA levels, improve the degree of pain and joint swelling, and will not increase the adverse reactions.