[目的]观察双醋瑞因对骨关节炎(Osteoarthritis,OA)的疗效及安全性.[方法]将我院2008年1至月2011年5月收治的符合美国风湿病学院膝骨关节炎的诊断标准的75例膝骨关节炎患者,随机法分为治疗组和对照组两组,两组差异无统计学意义(P＞0.05),符合可比性条件.治疗组37例,口服双醋瑞因胶囊50mg/次,1次/d.对照组38例,口服双氯芬酸钠肠溶片,75～150mg/d,分3次服(急性疼痛者可遵医嘱).两组均治疗12周后停药,并随访4周.治疗前及16周后均行X线检查,观察两组疗效、不良反应、放射学改变.[结果]两组治疗均有效,总有效率治疗组89.1％,对照组86.8％,两组无统计学差异(P＞0.05)；对照组起效较快,时间为(6.72±0.61)d,治疗组为(14.41±0.52)d,差异有统计学意义(P＜0.05)；不良反应以胃肠道反应为主,治疗组发生率为5.4％,对照组为10.5％,差异有统计学意义(P＜0.05)；16周后膝关节放射学检查:治疗组改善明显,有统计学意义(P＜0.05),对照组无明显差异,无统计学意义(P＞0.05),组间比较,有统计学差异(P＜0.05).[结论]双氯芬酸钠虽能较快的缓解疼痛症状,但不能控制疾病进展,对关节结构的重塑无效,而双醋瑞因在有效缓解疼痛的同时,可以控制关节进一步破坏,不良反应少,故对疼痛比较明显者,短期联合使用双氯芬酸钠可能会较快缓解临床症状.%[Objecrive] To observe the cure effect and safety of OA treated with Diacerein. [Method] Randomly divide 75 cases into 2 groups who had no difference of statistical meaning, with comparability. The treatment group 37 cases took Diacerein capsule; control group 38 cases, Diclofenac Sodium Enteric-coated Tablet. Both had treatment course of 12w and followed up for 4w. Make X-test to them before treatment and 16w after treatment; observe their effects, side effects and radioactive changes. [Result] The total effective rates were 89.1% and 86.8% for the 2 groups respectively, without statistical meaning; the control one had more quick effect, the time was (6.72±0.61)d,and (14.41±0.52)d for treatment group, with difference of statistical meaning; the side effects were mainly of gastric-intestinal reaction, the occurrence rate was 5.4% for treatment group and 10.5% for control one, with difference of statistical meaning; after 16w, make radiative test: the treatment group improved a lot with statistical meaning; the control group had no marked difference without statistical meaning. [Conclusion] Though Diacerein can effectively relieve pain and meanwhile control further injury of joint, with little bad effects; so, to those with obvious pain, short-rime using Diclofenac Sodium can more quickly relieve clinical symptoms.
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