Moore Nicholas
CHU de Bordeaux, Hôpital Pellegrin, Bordeaux, France.
Int J Clin Pract Suppl. 2003 Apr(135):28-31.
Low-dose ibuprofen is as effective as aspirin and paracetamol for the indications normally treated with over-the-counter (OTC) medications and is associated with the lowest risk of gastrointestinal toxicity of any non-steroidal anti-inflammatory drug. By contrast, even low-dose aspirin is associated with an appreciable risk of gastrointestinal toxicity. Paracetamol is well tolerated and effective in treating mild to moderate pain but there is growing concern about a possible risk of gastrointestinal toxicity and a possible link with asthma in children. The PAIN (Paracetamol, Aspirin, Ibuprofen New tolerability) study was a blinded randomised comparison of the tolerability of OTC analgesics in the treatment of common types of acute pain encountered in the community. A total of 8,677 adults were randomised to treatment with ibuprofen 1200 mg/day, paracetamol 3 g/day or aspirin 3 g/day for 1-7 days. The most common indications for treatment were musculoskeletal conditions (31-33%), colds or flu (19-20%), backache (15-17%), sore throat (11-12%) and headache (10-11%). Significant adverse events were more common with aspirin (10.1%) than ibuprofen (7.0%) (P<0.001) or paracetamol (7.8%). Significant gastrointestinal events were less frequent with ibuprofen (4.0%) than with aspirin (7.1%, P<0.001) or paracetamol (5.3%) (P=0.025). For every 100 patients treated, five more will experience significant adverse events if they are taking aspirin rather than ibuprofen, and four more than if they were taking paracetamol.
低剂量布洛芬在用于非处方（OTC）药物通常治疗的适应症时，其效果与阿司匹林和对乙酰氨基酚相当，并且在所有非甾体抗炎药中，它导致胃肠道毒性的风险最低。相比之下，即使是低剂量阿司匹林也有明显的胃肠道毒性风险。对乙酰氨基酚耐受性良好，在治疗轻至中度疼痛方面有效，但人们越来越担心其可能存在胃肠道毒性风险，以及可能与儿童哮喘有关。PAIN（对乙酰氨基酚、阿司匹林、布洛芬新耐受性）研究是一项关于OTC镇痛药治疗社区中常见急性疼痛类型时耐受性的双盲随机对照研究。共有8677名成年人被随机分配接受1200毫克/天布洛芬、3克/天对乙酰氨基酚或3克/天阿司匹林治疗1 - 7天。最常见的治疗适应症为肌肉骨骼疾病（31 - 33%）、感冒或流感（19 - 20%）、背痛（15 - 17%）、喉咙痛（11 - 12%）和头痛（10 - 11%）。阿司匹林组（10.1%）的严重不良事件比布洛芬组（7.0%）（P<0.001）和对乙酰氨基酚组（7.8%）更常见。布洛芬组（4.0%）的严重胃肠道事件比阿司匹林组（7.1%，P<0.001）和对乙酰氨基酚组（5.3%）（P = 0.025）更少。每100名接受治疗的患者中，如果服用阿司匹林而非布洛芬，会多5人出现严重不良事件；如果服用阿司匹林而非对乙酰氨基酚，则会多4人出现严重不良事件。
