Huskisson E C
St. Bartholomew's Hospital, London, England.
Scand J Rheumatol Suppl. 1988;77:34-6. doi: 10.3109/03009748809096933.
Many treatments have been shown to relieve symptoms in osteoarthritis but none have been found to influence the course of the disease. In the context of a symposium on cartilage changes in osteoarthritis, the major interest is in the possible action of non-steroidal anti-inflammatory drugs, either favourable or unfavourable, on the progression of cartilage destruction in this disease. On the one hand, there is experimental evidence that some anti-inflammatory drugs like indomethacin can adversely affect cartilage or interfere with repair mechanisms. Others like tiaprofenic acid do not have such effects. There is largely anecdotal evidence that indomethacin therapy can lead to rapid progression of hip disease in osteoarthritis. On the other hand, it is traditionally postulated that the process of inflammation with the release of enzymes and other noxious substances in diseases like rheumatoid arthritis, leads to cartilage damage. Anti-inflammatory drugs might be expected to inhibit such a process as they do in animal models. The long term actions of anti-inflammatory drugs are now being explored in a large scale prospective trial which should provide an answer to the question of whether anti-inflammatory drugs are good or bad for osteoarthritis. Meantime they remain the major symptomatic therapy for the disease.
许多治疗方法已被证明可缓解骨关节炎的症状，但尚未发现有任何一种方法能影响该病的病程。在关于骨关节炎软骨变化的研讨会上，主要关注点在于非甾体抗炎药对该病软骨破坏进展可能产生的作用，无论是有利还是不利的作用。一方面，有实验证据表明，一些抗炎药如吲哚美辛会对软骨产生不利影响或干扰修复机制。而其他药物如噻洛芬酸则没有此类作用。有大量传闻证据表明，吲哚美辛治疗可导致骨关节炎患者髋关节疾病迅速进展。另一方面，传统观点认为，在类风湿关节炎等疾病中，炎症过程伴随着酶和其他有害物质的释放，会导致软骨损伤。抗炎药可能像在动物模型中那样抑制这一过程。目前正在进行一项大规模前瞻性试验，以探索抗炎药的长期作用，该试验应能回答抗炎药对骨关节炎有益还是有害这一问题。与此同时，它们仍然是该病的主要对症治疗药物。
