依托考昔治疗原发性急性重度痛风性关节炎的临床疗效

Effects of Etoricoxib on primary acute severe gouty arthritis

目的:观察依托考昔治疗原发性急性重度痛风性关节炎的临床疗效。方法:选取72例原发性急性重度痛风性关节炎患者作为观察对象,采用随机数字表法将其分为观察组和对照组各36例。观察组给予依托考昔片治疗,对照组给予双氯芬酸钠缓释片治疗。比较两组治疗前后的血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、超敏C反应蛋白(Hs-CRP)水平,观察两组关节疼痛和关节肿胀改善情况,比较两组治疗总有效率和不良反应发生率。结果:治疗后,观察组TNF-α、IL-6、Hs-CRP、关节疼痛评分、关节肿胀评分、不良反应发生率均明显低于对照组,治疗总有效率明显高于对照组,差异均有统计学意义(P<0.05)。结论:依托考昔治疗原发性急性重度痛风性关节炎的临床疗效优于双氯芬酸钠,且不良反应发生率低,抑制炎性细胞因子的释放可能是其重要的作用机制。

Objective： To investigate clinical effects of Etoricoxib in treatment of primary acute severe gouty arthritis. Methods： A total of 72 patients with primary acute severe gouty arthritis were used as research objects and divided into 2 groups according to the random number table method： observation group（ n = 36） was treated with Etoricoxib tablets,while the control group（ n = 36）was given Diclofenac sodium sustained-release tablets. The levels of serum tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6）,and hypersensitive C-reactive protein（ hs-CRP） before and after the treatment were compared between the two groups. The joint pain and swelling improvement were observed for the two groups. Further,the total effective rate and adverse drug reaction rate were compared between the two groups. Results： After the treatment,the levels of serum TNF-α,IL-6,and hs-CRP,the scores of joint and joint swelling,and the adverse drug reaction rate in the observation group were significantly lower than those in the control group,while the total effective rate was obviously higher than that in the control group,and the differences were statistically significant（ P〈0.05）. Conclusions： Etoricoxib in the treatment of primary acute severe gouty arthritis is more effective than Diclofenac sodium sustained-release tablets with low adverse drug reaction rate,and the inhibition of the release of inflammatory cytokines may be its important mechanism.