来源：风湿病与关节炎,2023,12（6）:18-22.

双醋瑞因胶囊联合醋氯芬酸肠溶片和非布司他片治疗慢性痛风性关节炎80例临床观察（临床研究）

李　燕，李　漪，刘江南，巫婷婷

　　【摘　要】目的：观察双醋瑞因胶囊联合醋氯芬酸肠溶片和非布司他片治疗慢性痛风性关节炎患者的临床疗效。方法：将160例慢性痛风性关节炎患者随机分为治疗组和对照组，每组80例。对照组给予非甾体抗炎药醋氯芬酸肠溶片和降尿酸药非布司他片口服治疗；治疗组在对照组治疗基础上加服双醋瑞因胶囊。2组均以12周为1个疗程。观察2组患者治疗前后临床症状［关节肿痛数、急性发作次数、关节疼痛视觉模拟评分法（VAS）评分］及患者自我感觉的总体评估（PGA评分）；红细胞沉降率（ESR），C反应蛋白（CRP），血尿酸（UA），三大常规（血、尿、大便常规），肝功能，肾功能等；运用肌骨超声描述病变关节“关节积液”的影像学变化情况。结果：治疗组显效25例，有效50例，无效5例，总有效率为93.75%；对照组显效10例，有效55例，无效15例，总有效率为81.25%。2组比较，差异有统计学意义（P < 0.05）。治疗4，8，12周后，2组关节肿痛数、急性发作次数、VAS评分、患者PGA评分、ESR、CRP、UA较治疗前均显著改善（P < 0.05）；治疗组上述指标随着治疗时间的延长，疗效逐渐增加，具有时效性（P < 0.05）；对照组治疗12周后，上述指标水平较治疗4，8周后明显改善，差异有统计学意义（P﹤0.05）。治疗8，12周后，治疗组上述指标均优于对照组（P < 0.05）。治疗12周后，2组患者关节积液分级较治疗前均有明显改善（P < 0.05）；且治疗组优于对照组（P < 0.05）。不良反应率治疗组为23.75%，对照组为22.50%，2组比较，差异无统计学意义（P > 0.05）。结论：双醋瑞因胶囊联合醋氯芬酸肠溶片和非布司他片能明显缓解慢性痛风性关节炎的慢性关节滑膜炎症，减少急性发作，较好地控制病情。

　　【关键词】　慢性痛风性关节炎；双醋瑞因胶囊；醋氯芬酸肠溶片；非布司他片；临床疗效

Clinical Observation on the Treatment of 80 Cases of Chronic Gouty Arthritis with Diacerein Capsules and Aceclofenac Enteric-Coated Tablets and Febuxostat Tablets

LI Yan,LI Yi,LIU Jiang-nan,WU Ting-ting

　　【ABSTRACT】Objective:To observe the clinical efficacy of Diacerein Capsules combined with Aceclofenac Enteric-Coated Tablets and Febuxostat Tablets in the treatment of chronic gouty arthritis.Methods:One hundred and sixty patients with chronic gouty arthritis were randomly divided into a treatment group and a control group,with 80 cases in each group.The control group was given Aceclofenac Enteric-Coated Tablets,a nonsteroidal anti-inflammatory drug and Febuxostat tablets,an acid lowering drug,orally.On the basis of the treatment as in the control group,the treatment group was also given Diacerein Capsules.Both groups were treated for twelve weeks as a course of treatment.Both groups were observed on the aspects of the clinical symptoms［the number of joint swelling and pain,the number of acute attacks,the visual analogue scale（VAS）score of joint pain］and the physician global assessment score（PGA score）before and after treatment,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,blood uric acid（UA）,three routines（blood,urine and stool routines）,liver function,and kidney function.Musculoskeletal ultrasound was used to describe the imaging changes of "joint effusion" in the affected joint.Results:In the treatment group,

25 cases were significantly effective,50 cases were effective,and 5 cases were ineffective,with a total effective rate of 93.75%;in the control group,10 cases were significantly effective,55 cases were effective,and 15 cases were ineffective,with a total effective rate of 81.25%.The difference between the two groups was statistically significant

（P < 0.05）.After 4,8,and 12 weeks of treatment,the number of joint swelling and pain,number of acute attacks,VAS,PGA score,ESR,CRP,and UA in both groups were significantly improved compared to before treatment（P < 0.05）.The above indicators in the treatment group gradually increased with the prolongation of treatment,having timeliness（P < 0.05）.After 12 weeks of treatment,the levels of the above indicators in the control group were significantly improved compared to those after 4 and 8 weeks of treatment,with a statistically significant difference（P < 0.05）.After 8 and 12 weeks of treatment,the above indicators in the treatment group were better than those in the control group（P < 0.05）.After 12 weeks of treatment,the grading of joint effusion in both groups of patients showed significant improvement compared to before treatment（P < 0.05）,and the treatment group was superior to the control group（P < 0.05）.The adverse reaction rate was 23.75% in the treatment group and 22.50% in the control group.There was no statistically significant difference between the two groups（P > 0.05）.Conclusion:Diacerein Capsules combined with Aceclofenac Enteric-Coated Tablets and Febuxostat Tablets can significantly alleviate the chronic synovial inflammation of chronic gouty arthritis,reduce the acute attack,and better control the disease.

　　【Keywords】 chronic gouty arthritis;Diacetirin;Aceclofenac Enteric-Coated Tablets;Febuxostat Tablets;

clinical efficacy