塞来昔布治疗膝关节骨关节炎的作用机制及安全性

Study on the mechanism and safety of celecoxib in the treatment of knee osteoarthritis

目的基于药理学分析塞来昔布治疗膝关节骨关节炎的作用机制及用药安全性。方法选取2017年6月-2018年9月医院门诊接诊的轻、中度膝关节骨关节炎患者220例,随机分为研究组和对照组各110例。对照组患者口服双氯芬酸钠缓释片100 mg,每天1次,研究组患者口服塞来昔布胶囊200 mg,每天1次,2组患者均连续规律服药3周。对比2组患者治疗前后关节液白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及前列腺素E2(PGE2)变化情况及用药不良反应发生情况。结果用药前2组患者关节液炎性因子IL-1、IL-6、TNF-α及PGE2水平比较差异无统计学意义(P>0.05),用药后2组患者关节液炎性因子IL-1、IL-6、TNF-α及PGE2水平均较治疗前显著降低,且研究组患者降低更为明显,差异均有统计学意义(P<0.05)。用药期间,研究组患者的药物相关不良反应发生率为7.27%低于对照组患者的15.45%,差异有统计学意义(P<0.05)。结论塞来昔布可有效降低膝关节骨关节炎患者关节液IL-1、IL-6、TNF-α及PGE2水平,从而有效治疗膝关节骨关节炎,同时其药物不良反应发生率较低,用药安全性较高,应在临床上广泛应用。

Objective To analyze the mechanism and safety of celecoxib in the treatment of knee osteoarthritis based on pharmacology.Methods A total of 220 patients with mild to moderate knee osteoarthritis,who were admitted in hospital outpatient clinic from June 2017 to September 2018,were randomly divided into study group and control group,each of 110 cases.Control group received oral diclofenac sodium sustained-release tablets 100 mg once a day,patients in study group received oral celecoxib capsules 200 mg once a day,the two groups of patients were given regular regular medication for 3 weeks.Observed the joint fluid IL-1,IL-6,TNF-αand PGE2 changes and the occurrence of adverse drug reactions before and after treatment in two groups.Results There were no significant differences in the levels of inflammatory factors IL-1,IL-6,TNF-αand PGE2 between two groups before treatment(P>0.05).After treatment,the levels of inflammatory factors IL-1,IL-6,TNF-αand PGE2 in two groups were significantly lower than those before treatment,and the decrease was more significant in study group,the difference was statistically significant(P<0.05).During the treatment,the incidence of drug-related adverse reactions in study group(7.27%)was lower than that of control group(14.75%),which was statistically significant(P<0.05).Conclusion Celecoxib can effectively reduce the joint fluid IL-1,IL-6,TNF-αand PGE2 in patients with knee osteoarthritis,thus effectively treating knee osteoarthritis,and the incidence of adverse drug reactions is relatively low,the medication is safe and should be widely used in clinical practice.