| Objective To investigate the efficacy and safety of dexamethasone in the reatment of acute gouty arthritis by means of ultrasonic conductivity apparatusMethods Through clinical screening,from November 2015 to October 2016,56 patients with acute gouty arthritis were enrolled in the Department of metabolism and gout clinic of Qingdao University,using random numbers to patients randomly assigned to the experimental group of 30 cases and 26 patients into two groups.Observation of all subjects for a period of 14 days.Control group program: arcoxia 120 mg qd,application 3days,4th day to 60 mg qd for 4 days in a row;colchicine 0.5mg bid,sodium bicarbonate1.0g bid,last 14 days;Inspection group therapy: treatment plan on the basis of the 1th to5 th day in the control group to attack the joints using ultrasonic conductivity meter local giving dexamethasone treatment.1th to 14 th day,respectively compared two groups of patients with joint pain scores(VAS score),swelling score,venous blood samples were taken at day 1,3,5,7,14,and laboratory biochemical parameters of the two groups were compared and analyzed: Serum uric acid(UA),c-reactive protein(CRP),erythrocyte sedimentation rate(ESR),Interleukin 1 beta(IL-1 Beta),tumor necrosis factor-?(TNF-?),and to evaluate the changes of gastrointestinal reactions,blood sugar,blood pressure and liver and kidney function were measured before and after the test.Statistical analysis using the SPSS17.0 software for data processing and quantitative data using T test,qualitative information is expressed as a percentage and using chi-square test(n<30,statistics by the Fisher exact probability method).The statistical result was P<0.05,the difference was statistically significant.Results A total of 56 patients into trials,of which 4 patients were excluded because of the loss.Finally,28 cases in the experimental group and 24 cases in the control group were followed up and included in the statistical objects.The joint pain scores(VAS score)of the experimental group and the control group,sections 3,4,5,6,8,9,10,11,12,13,14,the difference was statistically significant(F=3.98-9.31,P<0.05,0.01);Swollen joint scores between the experimental group and control groups,sections 3,4,5,7,8,9,10,11,12,13,14,the difference was statistically significant(F=3.98-9.73,P<0.05,0.01).The biochemical indices of the experimental group and the control group were compared,IL1-? 3,5,7 day test group were lower than the control group,the difference was statistically significant(F=4.12,4.02,P<0.05),TNF-? 5,7 day test group were lower than the control group,the difference was statistically significant(F=4.02,4.02,P<0.05),ESR3,5,7 day test group were lower than the control group,the difference was statistically significant(F=4.02,4.12,P<0.05),CRP 3,5,7 day test group were lower than the control group,the difference was statistically significant(F=4.02,4.50,P<0.05);compare the incidence of side effects of the experimental group and the control group,there was no statistically significant differences in the incidence of gastrointestinal reactions(mild nausea,stomach upset)(c 2=0.59,P>0.05),blood pressure(SBP increased >20mm Hg)(c2=0.21,P>0.05),and there were no obvious cases of elevated blood sugar and abnormal liver and kidney function in the two groups.Conclusion Local application of dexamethasone in the treatment of acute gouty arthritis with ultrasonic conductivity apparatus can improve the efficacy of anti-inflammatory and analgesia,and has good safety. |
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