右旋布洛芬和萘普生在治疗儿童幼年特发性关节炎中的对照观察

An observational study of Dexibuprofen and Naproxen in the treatment of juvenile idiopathic arthritis in children

目的比较右旋布洛芬和萘普生治疗儿童幼年特发性关节炎的有效性及安全性。方法回顾性分析2017年3月至2018年6月在华中科技大学同济医学院附属武汉儿童医院收治的幼年特发性关节炎患儿,根据使用止痛药类型分为右旋布洛芬组(观察组)和萘普生组(对照组),观察组按每次7 mg/kg,2次/d,对照组按照每次5 mg/kg,2次/d。采用疼痛视觉模拟评分(VAS)评价2组患儿用药前后不同时段的关节疼痛缓解情况及药物使用不良反应。结果本研究共纳入97例患儿,其中观察组48例,对照组49例。2组患儿性别、年龄、受累关节部位差异均无统计学意义(均P>0.05)。医师(P=0.736)和患儿及家长(P=0.563)均认为2组患儿镇痛效果差异无统计学意义,但医师(P=0.025)和患儿及家长(P=0.024)认为右旋布洛芬耐受性评分更高。观察组胃肠道不良反应发生率[4.2%(2/48例)]低于对照组[18.4%(9/49例)],差异有统计学意义(χ^2=4.863,P=0.027)。结论右旋布洛芬与萘普生治疗幼年特发性关节炎患儿的镇痛效果相似,右旋布洛芬具有更优的耐受性和更低的胃肠道不良反应。

Objective To compare the efficacy and safety of Dexibuprofen and Naproxen in the treatment of juvenile idiopathic arthritis.Methods The data of children with juvenile idiopathic arthritis admitted to Wuhan Children's Hospital,Tongji Medical College of Huazhong University of Science and Technology from March 2017 to June 2018 were retrospectively analyzed.According to the types of painkillers used,the children were divided into the Dexibuprofen group(observation group)and Naproxen group(control group).The observation group was given 7 mg/kg Dexibuprofen each time and twice one day,while the control group was given 5 mg/kg Naproxen each time and twice one day.Visual analogue scale(VAS)was used to evaluate the relief of joint pain and adverse drug reactions before and after medication in the 2 groups.Results A total of 97 children were enrolled in this study,including 48 in the observation group and 49 in the control group.There were no significant differences in gender,age and the joint location between the 2 groups(all P>0.05).Doctors(P=0.736),children and their families(P=0.563)all agreed that there was no significant difference in the analgesic effect between the 2 groups,but the tolerance score of Dexibuprofen was higher that of Naproxen[doctors(P=0.025),children and their families(P=0.024)].The incidence of gastrointestinal adverse reactions was 4.2% in the observation group(2 cases)and 18.4% in the control group(9 cases),and the difference between 2 groups was significant(χ^2=4.863,P=0.027).Conclusions The analgesic effect of Dexibuprofen is same to that of Naproxen in the treatment of children with juvenile idiopathic arthritis,but Dexibuprofen has a better tolerance rate and causes less gastrointestinal adverse reactions.