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目的：观察环氧化酶-2 抑制剂依托考昔治疗急性痛风性关节炎的疗效和安全性。方法：选择到我院就诊急性痛风发作患者 113例，按随机平行对照原则分为治疗组（给予依托考昔120 mg/d，57 例)和对照组双氯芬酸钠(双氯芬酸钠组75 mg/d，56 例)。两组病人均给与相同的基础治疗如低嘌呤饮食、多饮水、卧床休息、碱化尿液等。选初诊、服药后的第4 小时、第2、5 天为观察点，对患者病变关节进行疼痛评分和肿胀评分，并记录药物不良反应。检测两组服药前及服药后第5 天血细胞分析、血沉、C 反应蛋白、肝功、肾功的变化。结果：与对照组相比，治疗组在缓解急性痛风性关节炎的炎症方面效果显著，治疗组C 反应蛋白水平、血沉下降水平明显高于对照组（P<0.05）；治疗组患者病变关节疼痛及肿胀程度与对照组相比明显缓解（P<0.05）。治疗组不良反应发生率为3.5%；对照组发生率为5.3%，差异无统计学意义。结论：环氧化酶-2 抑制剂依托考昔治疗急性痛风性关节炎起效快，镇痛效果优于双氯芬酸钠，安全性及耐受性好。

英文摘要:

Objective:To observe the efficacy and safety of COX-2 inhibitors etoricoxib in the treatment of patients with acute gouty arthritis.Methods:113 patients with acute gouty arthritis were divided into two groups by andomized parallel control principle, etorieoxib group(120 mg/d , n=57) and Diclofenac sodiumgroup (75 mg/d, n=56) as control. Two groups of patients were given the same basic treatment such as a low-purine diet, drink more water, bed rest, alkalization of urine. Pain scores and swelling scores of patients with lesions of the joints and adverse drug reactions were recorded at 0 hour, 4 hours, 2 days, 5 days after taking medicines. Blood cells, erythrocyte sedimentation rate, C-reactive protein, liver function, renal function were detected before taking medicine and 5 days after taking in both groups.Results:Compared with the control group, etoficoxib group significantly alleviated the inflammation of acute gouty arthritis, C-reactive protein levels, erythrocyte sedimentation rate decreased significantly higher than that in the control group（P< 0.05）. Pain and swelling degree of joints in etoficoxib group were alleviated significantly compared to the control group（P<0.05）. The incidences of adverse reactions were not different in two groups, 3.5% in etoficoxib group, and 5.3% in the control group.Conclusion:Etoricoxib may be rapid onset and more effective than diclofenac for acute gouty arthritis in aspects of safety and tolerance.

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