Calin A
Am J Med. 1984 Sep 10;77(3A):9-16. doi: 10.1016/s0002-9343(84)80098-4.
The traditional "aspirin first" approach to the treatment of osteoarthritis and rheumatoid arthritis is undergoing serious reappraisal. Aspirin and acetaminophen are equipotent in their analgesic efficacy; however, aspirin is associated with a higher incidence of side effects. Acetaminophen should therefore be used as first-line therapy for the treatment of osteoarthritis since reduction of pain is the primary therapeutic objective. Analgesic doses of aspirin (up to 3,900 mg per day) do not produce an anti-inflammatory effect and thus are not beneficial in the treatment of rheumatoid arthritis. Only high doses of aspirin (4 to 6 g per day) used for a sustained period produce an anti-inflammatory effect. Since many patients with rheumatoid arthritis cannot tolerate long-term use of anti-inflammatory doses of aspirin, it may be preferable to initiate therapy with one of the newer nonsteroidal anti-inflammatory drugs.
传统的治疗骨关节炎和类风湿关节炎的“先使用阿司匹林”方法正在受到认真的重新评估。阿司匹林和对乙酰氨基酚在镇痛效果上相当；然而，阿司匹林的副作用发生率更高。因此，对乙酰氨基酚应作为骨关节炎治疗的一线疗法，因为减轻疼痛是主要治疗目标。阿司匹林的镇痛剂量（每天高达3900毫克）不会产生抗炎作用，因此对类风湿关节炎的治疗没有益处。只有持续使用高剂量阿司匹林（每天4至6克）才会产生抗炎作用。由于许多类风湿关节炎患者无法耐受长期使用抗炎剂量的阿司匹林，因此开始治疗时使用一种较新的非甾体抗炎药可能更为可取。
