双氯芬酸与对乙酰氨基酚治疗膝骨关节炎的疗效比较：一项初级保健中的随机对照试验
Effectiveness of diclofenac versus paracetamol in knee osteoarthritis: a randomised controlled trial in primary care.
作者信息
Verkleij Saskia P J, Luijsterburg Pim A J, Willemsen Sten P, Koes Bart W, Bohnen Arthur M, Bierma-Zeinstra Sita M A
机构信息
Department of General Practice;
Department of Biostatistics, Erasmus MC University Medical Center Rotterdam, the Netherlands.
出版信息
Br J Gen Pract. 2015 Aug;65(637):e530-7. doi: 10.3399/bjgp15X686101.
BACKGROUND
The effectiveness of diclofenac versus paracetamol in primary care patients with pain caused by knee osteoarthritis is unclear.
AIM
To assess the effectiveness of diclofenac compared with paracetamol over a period of 2, 4, and 12 weeks in patients with knee osteoarthritis.
DESIGN AND SETTING
Randomised controlled trial in general practice.
METHOD
There were 104 patients included in the study, they were aged ≥45 years consulting their GP with knee pain caused by knee osteoarthritis. Patients were randomly allocated to diclofenac (n = 52) or paracetamol (n = 52) for at least 2 weeks. Primary outcomes were daily knee pain severity, and knee pain and function measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS).
RESULTS
Over a period of 2- and 4-weeks follow-up, no significant difference in daily knee pain was found between the patient groups: estimated differences of 0.5 (95% CI = -0.2 to 1.3) and -0.2 (95% CI = -1.0 to 0.7), respectively. Over the 12-weeks follow-up, no significant differences were found between both groups for KOOS pain: estimated difference of -2.8 (95% CI = -10.7 to 5.1) and KOOS function of -2.7 (-10.6 to 5.0).
CONCLUSION
Over a period of 2- and 4-weeks follow-up no significant difference in daily measured knee pain severity was found between primary care patients with knee osteoarthritis taking paracetamol or diclofenac. Also, over a period of 12-weeks follow-up no significant differences were found regarding KOOS pain and KOOS function between both groups. Patients more frequently reported minor adverse events after taking diclofenac (64%) than paracetamol (46%).
背景
双氯芬酸与对乙酰氨基酚对基层医疗中因膝关节骨关节炎引起疼痛的患者的疗效尚不清楚。
目的
评估双氯芬酸与对乙酰氨基酚在膝关节骨关节炎患者中2周、4周和12周期间的疗效。
设计与地点
全科医疗中的随机对照试验。
方法
104名年龄≥45岁、因膝关节骨关节炎导致膝关节疼痛而咨询全科医生的患者纳入研究。患者被随机分配至双氯芬酸组（n = 52）或对乙酰氨基酚组（n = 52），治疗至少2周。主要结局为每日膝关节疼痛严重程度，以及采用膝关节损伤和骨关节炎结局评分（KOOS）测量的膝关节疼痛和功能。
结果
在2周和4周的随访期内，患者组间每日膝关节疼痛无显著差异：估计差异分别为0.5（95%CI = -0.2至1.3）和 -0.2（95%CI = -1.0至0.7）。在12周的随访期内，两组在KOOS疼痛方面无显著差异：估计差异为 -2.8（95%CI = -10.7至5.1），KOOS功能差异为 -2.7（-10.6至5.0）。
结论
在2周和4周的随访期内，服用对乙酰氨基酚或双氯芬酸的基层医疗膝关节骨关节炎患者每日测量的膝关节疼痛严重程度无显著差异。此外，在12周的随访期内，两组在KOOS疼痛和KOOS功能方面也无显著差异。服用双氯芬酸后报告轻微不良事件的患者（64%）比服用对乙酰氨基酚的患者（46%）更频繁。
Zotero 插件