Lee M
Department of Internal Medicine, University of Texas Health Science Center, San Antonio 78284-7878, USA.
South Med J. 1995 May;88(5):507-13. doi: 10.1097/00007611-199505000-00001.
Numerous human studies have shown that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with various gastroduodenal mucosal lesions, collectively referred to as NSAID gastropathy. NSAIDs should not be prescribed unless there is a clear-cut indication for them. Acetaminophen should be used initially to treat most patients with osteoarthritis. If NSAID therapy is required, the lowest possible NSAID dose should be prescribed, and the patient should be advised to reduce any modifiable risk factors. In patients who take NSAIDs occasionally and are at low risk for NSAID gastropathy, no specific prophylactic measures seem justified. In high-risk NSAID users, risk reduction and prophylaxis with misoprostol would be appropriate. If an ulcer is documented during NSAID treatment, NSAID therapy should be discontinued if possible. However, NSAID therapy need not be discontinued if it is therapeutically justifiable and if appropriate antiulcer treatment is initiated.
众多人体研究表明，使用非甾体抗炎药（NSAIDs）与各种胃十二指肠黏膜病变相关，统称为NSAID胃病。除非有明确的用药指征，否则不应开具NSAIDs处方。对大多数骨关节炎患者，应首先使用对乙酰氨基酚进行治疗。如果需要使用NSAID治疗，应开具尽可能低的NSAID剂量，并建议患者减少任何可改变的风险因素。对于偶尔服用NSAIDs且患NSAID胃病风险较低的患者，似乎没有必要采取特定的预防措施。对于NSAID高风险使用者，使用米索前列醇降低风险并进行预防是合适的。如果在NSAID治疗期间记录到溃疡，若可能应停用NSAID治疗。然而，如果治疗合理且开始了适当的抗溃疡治疗，则不必停用NSAID治疗。
