類風濕性關節炎的循證治療_《中國循證醫學雜志》

作者：

岳冀蓉 , 郭佳 , 楊茗 , 董碧蓉

四川大學華西醫院老年科,成都,610041;

關鍵詞：

類風濕性關節炎循證治療

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

類風濕性關節炎是一種慢性炎癥性疾病,以侵犯外周關節和關節周圍組織的慢性多關節炎為其特點.針對1例類風濕性關節炎患者,筆者進行了證據檢索,將經驗治療與當前最佳的干預措施結合起來,制定出適合該患者的治療方案:①鎮痛選用布洛芬;②繼續靜脈滴注甲氨蝶呤進行抗類風濕治療,但出院后改為甲氨蝶呤每周1次口服,療程初步確定為12個月;③奧美拉唑20 mg,qd,口服,預防消化道潰瘍的發生;④建議患者出院后使用魚油并且堅持鍛煉.

引用本文： 岳冀蓉,郭佳,楊茗,董碧蓉. 類風濕性關節炎的循證治療. 中國循證醫學雜志, 2004, 04(5): 351-354. doi: 復制

1.	［1］Rostom A, Dube C, Wells G, Tugwell P, Welch V, Jolicoeur E,McGowan J. Prevention of chronic NSAID induced upper gastrointestinal toxicity[ M/CD]. In: The Cochrane Library,Issue 1, 2003. Oxford: Update Software.
2.	［2］Gotzsche PC, Johansen HK. Short-term low-dose corticosteroids vs placebo and nonsteroidal antiinflammatory drugs in rheumatoid arthritis ( Cochrane Review) [ M/CD]. In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
3.	［3］Van Den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM. Dynamic exercise therapy for treating rheumatoid arthritis (Cochrane Review) [M/CD]. In: The Cochrane Library,Issue 1, 2003. Oxford: Update Software.
4.	［4］Gotzsche PC. Meta-analysis of NSAIDs: contribution of drugs,doses, trial designs, and meta-analytic techniques[J]. Scand J Rheumatol, 1993; 22(6): 255-260.
5.	［5］Moore RA, Tramer MR, Carroll D, Wiffen PJ, McQuay HJ.Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs[J]. BMJ, 1998; 316(7128): 333 -338.
6.	［6］Suarez-Almazor ME, Belseck E, Wells G, Shea B, Tugwell P.Meta-analyses of placebo controlled trails of disease-modifying antirheumatic drugs (DMARDs)for the treatment of rheumatoid arthritis(RA) [J]. Arthritis Rheum, 1998; 41 ( 12 ): s153.
7.	［7］Maetzel A, Wong A, Strand V, Tngwell P, Wells G, Bombardier C. Meta-analysis of treatment teminarion rates among rheumatoid arthritis patients receiving disease-modifying antitheimatic drugs[J]. Rheumatology (Oxford), 2000; 39(9): 975 -981.
8.	［8］Volker D, Fitzgerald P, Major G, Garg M. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis [ J ]. J Rheumatol, 2000; 27 (10) :2 343-2 346.
9.	［9］Hawkey CJ, Karrasch JA, Szczepanski L, Walker DG, Barkun A, Swannell AJ, Yeomans ND. Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group[J]. N Engl J Med, 1998; 338(11): 727-734.
10.	［10］Wolfe F, Hawley DJ, Cathey MA. Terminarion of slow acting antirheumatic therapy in rheumatoid arthritis: a 14-year prospective evaluation of 1017 consecutive starts [ J ]. J Rheumatol, 1990; 17(8): 994-1 002.
11.	［11］MacDonald TM, Morant SV, Robinson GC, Shield MJ,McGilchrist MM, Murray FE, McDevitt DG. Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study [J]. BMJ,1997; 315(7 119): 1 333 -1 337.
12.	［12］Henry D, Lim LL, Garcia Rodtiguez LA, Perez Gutthann S,Carson JL, Griffin M, Savage R, Logan R, Moride Y,Hawkey C, Hill S, Fries JT. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis [J]. BMJ,1996; 312(7 046): 1563-1566.

1. ［1］Rostom A, Dube C, Wells G, Tugwell P, Welch V, Jolicoeur E,McGowan J. Prevention of chronic NSAID induced upper gastrointestinal toxicity[ M/CD]. In: The Cochrane Library,Issue 1, 2003. Oxford: Update Software.
2. ［2］Gotzsche PC, Johansen HK. Short-term low-dose corticosteroids vs placebo and nonsteroidal antiinflammatory drugs in rheumatoid arthritis ( Cochrane Review) [ M/CD]. In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
3. ［3］Van Den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM. Dynamic exercise therapy for treating rheumatoid arthritis (Cochrane Review) [M/CD]. In: The Cochrane Library,Issue 1, 2003. Oxford: Update Software.
4. ［4］Gotzsche PC. Meta-analysis of NSAIDs: contribution of drugs,doses, trial designs, and meta-analytic techniques[J]. Scand J Rheumatol, 1993; 22(6): 255-260.
5. ［5］Moore RA, Tramer MR, Carroll D, Wiffen PJ, McQuay HJ.Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs[J]. BMJ, 1998; 316(7128): 333 -338.
6. ［6］Suarez-Almazor ME, Belseck E, Wells G, Shea B, Tugwell P.Meta-analyses of placebo controlled trails of disease-modifying antirheumatic drugs (DMARDs)for the treatment of rheumatoid arthritis(RA) [J]. Arthritis Rheum, 1998; 41 ( 12 ): s153.
7. ［7］Maetzel A, Wong A, Strand V, Tngwell P, Wells G, Bombardier C. Meta-analysis of treatment teminarion rates among rheumatoid arthritis patients receiving disease-modifying antitheimatic drugs[J]. Rheumatology (Oxford), 2000; 39(9): 975 -981.
8. ［8］Volker D, Fitzgerald P, Major G, Garg M. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis [ J ]. J Rheumatol, 2000; 27 (10) :2 343-2 346.
9. ［9］Hawkey CJ, Karrasch JA, Szczepanski L, Walker DG, Barkun A, Swannell AJ, Yeomans ND. Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group[J]. N Engl J Med, 1998; 338(11): 727-734.
10. ［10］Wolfe F, Hawley DJ, Cathey MA. Terminarion of slow acting antirheumatic therapy in rheumatoid arthritis: a 14-year prospective evaluation of 1017 consecutive starts [ J ]. J Rheumatol, 1990; 17(8): 994-1 002.
11. ［11］MacDonald TM, Morant SV, Robinson GC, Shield MJ,McGilchrist MM, Murray FE, McDevitt DG. Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study [J]. BMJ,1997; 315(7 119): 1 333 -1 337.
12. ［12］Henry D, Lim LL, Garcia Rodtiguez LA, Perez Gutthann S,Carson JL, Griffin M, Savage R, Logan R, Moride Y,Hawkey C, Hill S, Fries JT. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis [J]. BMJ,1996; 312(7 046): 1563-1566.

《中國循證醫學雜志》

類風濕性關節炎的循證治療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國循證醫學雜志》

類風濕性關節炎的循證治療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料