对乙酰氨基酚与非甾体抗炎药治疗骨关节炎的疗效和安全性的观察

THE EFFICACY AND SAFETY OF ACETAMINOPHEN VERSUS NSAIDs IN OSTEOARTHRITIS TREATMENT

摘要:

目的：比较对乙酰氨基酚、双氯芬酸钠、美洛昔康和布洛芬治疗骨关节炎的疗效和安全性。方法：采用多中心、随机、对照研究方法。每组30例。其中对乙酰氨基酚组口服1300mg，bid；双氯芬酸钠组口服25mg，tid；美洛昔康组口服7．5mg，qd；布洛芬组口服300mg，bid，共观察4周。结果：对乙酰氨基酚组的有效率为73．33％，双氯芬酸钠组为76．67％，美洛昔康组为76．67％，布洛芬组为70．00％，各组有效率无显著差异；4组患者的SF-36生活质量评分部分项目治疗前后有显著差异。各组不良反应发生率无显著差异，但实验室检查显示肝功能均有不同程度影响，以3种非甾体抗炎药尤为显著。结论：经4种药物治疗，骨关节炎患者的症状和生活质量均有改善，但4种药物对肝功能有一定的影响，临床长期运用要注意安全。

Abstract:

Objective: To compare the efficacy and safety of acetaminophen, diclofenac, meloxicam and ibuprofen in treating osteoarthritis(OA) patients. Methods: A multi center, randomized, case control study was adopted. Acetaminophen group(n=30) took 1300mg, bid; diclofenac group(n=30) 25mg tid; meloxicam group(n=30) 7.5mg qd and ibuprofen group (n=30) 300mg bid. The total course of treatment was 4 weeks. Results: The efficacy of acetaminophen, diclofenac, meloxicam and ibuprofen was 73.33%, 76.67%, 76.67% and 70.00% respectively and there is no significant difference ( P <0.05). The quality of life scores evaluated by SF 36 were significantly improved ( P <0.05). There is no significant difference in adverse drug reactions in 4 groups, but the liver function was affected, especially in 3 NSAIDs treating groups. Conclusion: The symptoms and quality of life scores were significantly improved in 4 groups. But all drugs affect the liver function, so attention should be paid to patients, with long term drug use.