Gillet P, Fener P, Jouzeau J Y, Netter P
Clinique rhumatologique, Faculté de Médecine, Vandoeuvre-lès-Nancy.
Rev Prat. 1994 Jan 15;44(2):201-5.
The treatment of acute crystal-induced inflammatory episodes is based on two major classes of drugs, colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs). In its capacity to inhibit leukocyte influx into the inflammatory site, colchicine demonstrates its remarkable anti-inflammatory properties in gouty attacks, for which it is a real therapeutic test. Nevertheless, at usual dosages, colchicine often induces gastrointestinal irritation manifested by diarrhoea. Other side effects (in particular haematologic) are rare but severe in case of liver or kidney failure, which are classic contraindications to this treatment. NSAIDs, by inhibiting local prostaglandin synthesis, are also highly effective in gouty attacks. This ubiquitous property nonetheless leads to side effects, mainly gastro-intestinal and renal. In gouty attacks, clinical steps include a diagnostic work-up seeking an aetiological cause, whereas episodes of chondrocalcinosis or apatite-induced rheumatism are treated symptomatically (rest of the joint, NSAIDs, sometimes colchicine, or local infiltration of cortisone derivatives).
急性晶体诱导性炎症发作的治疗基于两大类药物，即秋水仙碱和非甾体抗炎药（NSAIDs）。秋水仙碱能够抑制白细胞流入炎症部位，在痛风发作中展现出显著的抗炎特性，它是痛风治疗的一项实际检验标准。然而，在常用剂量下，秋水仙碱常常会引发以腹泻为表现的胃肠道刺激。其他副作用（尤其是血液方面的）较为罕见，但在肝肾功能衰竭的情况下会很严重，而肝肾功能衰竭是这种治疗的典型禁忌证。NSAIDs 通过抑制局部前列腺素合成，在痛风发作中也非常有效。不过，这种普遍存在的特性会导致副作用，主要是胃肠道和肾脏方面的。在痛风发作时，临床步骤包括寻找病因的诊断检查，而软骨钙质沉着症或磷灰石诱发的风湿症发作则进行对症治疗（关节制动、使用NSAIDs，有时使用秋水仙碱，或局部注射皮质类固醇衍生物）。
