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痛风性关节炎治疗进展:既定疗法、新兴疗法和生活方式干预的整合。

Advances in Gouty Arthritis Management: Integration of Established Therapies, Emerging Treatments, and Lifestyle Interventions.

机构信息

Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan.

Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan.

出版信息

Int J Mol Sci. 2024 Oct 9;25(19):10853. doi: 10.3390/ijms251910853.

Abstract

Gouty arthritis, a prevalent inflammatory condition characterized by the deposition of monosodium urate crystals within joints, often results in debilitating pain and inflammation. Conventional therapeutic approaches, including nonsteroidal anti-inflammatory drugs, corticosteroids, and urate-lowering agents such as allopurinol and febuxostat, often have limitations such as adverse effects, drug interactions, and suboptimal patient compliance. This review presents a comprehensive overview of both established and emerging therapeutic strategies, developed between 2019 and 2024, for gouty arthritis; the review focuses on their mechanisms of action, efficacy, and safety profiles. Novel therapeutic approaches include pharmaceutical plant additives (e.g., , ), anti-inflammatory agents such as canakinumab and ozone therapy, and complementary therapies such as warm ginger compresses, Qingpeng ointment, and various lifestyle modifications. These strategies offer promising alternatives to conventional treatments by targeting uric acid metabolism, inflammatory pathways, and crystal formation, potentially reducing reliance on standard medications and minimizing adverse effects. Although therapies such as canakinumab have demonstrated significant efficacy in reducing gout flares, others such as polyphenol-rich foods offer favorable safety profiles. Further research, including large-scale clinical trials, is warranted to validate these findings and integrate these strategies into clinical practice to improve patient outcomes and quality of life.

摘要

痛风性关节炎是一种常见的炎症性疾病,其特征是单钠尿酸盐晶体在关节内沉积,常导致严重的疼痛和炎症。传统的治疗方法,包括非甾体抗炎药、皮质类固醇和降尿酸药物,如别嘌醇和非布司他,常常存在副作用、药物相互作用和患者依从性差等局限性。本综述介绍了 2019 年至 2024 年期间开发的痛风性关节炎的既定和新兴治疗策略的全面概述;重点介绍了它们的作用机制、疗效和安全性概况。新的治疗方法包括药用植物添加剂(如 、 )、抗炎药物(如卡那单抗和臭氧疗法)以及温热姜敷、青鹏软膏和各种生活方式的改变等补充疗法。这些策略通过靶向尿酸代谢、炎症途径和晶体形成,提供了有前途的替代传统治疗的方法,可能减少对标准药物的依赖并最小化不良反应。虽然卡那单抗等疗法已被证明在减少痛风发作方面具有显著疗效,但多酚丰富的食物等其他疗法则具有良好的安全性。需要进一步的研究,包括大规模的临床试验,以验证这些发现,并将这些策略整合到临床实践中,以改善患者的结局和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f1b/11477016/3f6b92c344eb/ijms-25-10853-g001.jpg

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