Humans ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects* ; Aspirin/therapeutic use* ; Respiration Disorders ; Respiratory Tract Diseases

OBJECTIVETo observe the rate of efficacy and adverse drug reaction of non-steroidal anti-inflammatory drugs (NSAIDs) in the population with osteoarthritis and rheumatoid arthritis, based on available clinical data.

METHODSUsing Meta analysis to evaluate the data of effect and safety profile of NSAIDs from 19 articles on randomized clinical trials published from 1990 to 2001 in Chinese journals. The total number of patients enrolled for evaluation on rates of effectiveness and adverse drug reaction were 1 732 and 2 925, respectively.

RESULTSData on the effect and safety were comparatively heterogeneous among different kinds of NSAIDs. The effective rates (95% CI) were as follows: nabunetone, 66.7% (61.9% - 71.4%); meloxicam, 68.4% (59.2% - 77.6%); naproxen, 64.5% (59.8% - 69.1%); nimesulide, 79.8% (75.7% - 84.0%); ibuprofen, 77.2% (70.7% - 83.8%); diclofenac, 77.1% (69.2% - 85.0%); oxaprozin, 65.8% (59.5% - 72.0%). Rates of adverse drug reaction (95% CI) were as follows: nabunetone, 16.3% (12.5% - 20.0%); meloxicam, 10.2% (4.2% - 16.2%); naproxen, 29.2% (24.8% - 33.6%); nimesulide, 20.2% (16.0% - 24.3%); ibuprofen, 16.7% (14.7% - 18.8%); diclofenac, 19.3% (11.9% - 26.7%); oxaprozin, 12.7% (8.9% - 16.7%) respectively.

CONCLUSIONThe rates of effect and adverse reaction on patients having osteoarthritis and rheumatoid arthritis with NSAIDs treatment would largely depend on the drugs being used. Within 2 - 8 weeks of treatment, the effective rate and rate of adverse drug reaction with commonly used NSAIDs as nabumeton, meloxicam, etc., were 59.2% - 85.0% and 4.2% - 33.6%, respectively.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Butanones ; adverse effects ; therapeutic use ; China ; Diclofenac ; adverse effects ; therapeutic use ; Humans ; Ibuprofen ; adverse effects ; therapeutic use ; Naproxen ; adverse effects ; therapeutic use ; Osteoarthritis ; drug therapy ; Propionates ; adverse effects ; therapeutic use ; Randomized Controlled Trials as Topic ; Sulfonamides ; adverse effects ; therapeutic use ; Thiazines ; adverse effects ; therapeutic use ; Thiazoles ; adverse effects ; therapeutic use

Analgesics, Opioid ; adverse effects ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Clinical Trials as Topic ; Disease Management ; Humans ; Pain, Intractable ; drug therapy ; physiopathology

OBJECTIVETo explore the therapeutic effects of Xiaozhong Zhitong mixture preventing heterotopic ossification (HO) after total hip arthroplasty.

METHODSFrom July 2006 to October 2009, 154 patients underwent total hip replacement surgery were randomly divided into sham group (group A, 50 cases), indomethacin group (group B, 55 cases) and Xiaozhong Zhitong mixture group (group C, 49 cases). Among 154 patients, 9 cases were primary osteoarthris, 34 cases osteoarthritis secondary to acetabular dysplasia, 98 cases osteoarthritis secondary to avascular necrosis of the femoral head, 2 cases rheumatoid arthritis, 5 cases femoral neck fracture, 6 cases other diseases. Modified Gibson approach was used during the operation. After operation, group A was no preventing treatment, group B was treated by indomethacin 50 mg every time, twice a day; group C was treated by Xiaozhong Zhitong mixture 50 ml every time, twice a day for 4 weeks. Eighteen months after operation was study termination point and X-ray (including the double hip anteroposterior,obturator oblique and iliac oblique film) was used to observe whether heterotopic ossification was formed (Brooker classification was used to evaluate ossification degree); Harris scoring was used to evaluate the function of hip joint,including PAHSS 80 scores and IAHSS 20 scores.

RESULTSAll the patients were followed up,with the average of duration of 21.2 months. The condition of heterotopic ossification: for group A,there were 27 cases with heterotopic ossification(54%) ,and Brooker I in 8 cases, II in 9 cases, III in 8 cases and IVin 2 cases; for group B, there were 12 cases heterotopic ossification (21.82%), and Brooker I in 10 cases, II in 2 cases; for group C, there were 11 cases heterotopic ossification(22.45%), and Brooker I in 9 cases, I in 2 cases. There was significant difference among three group in heterotopic ossification by rank test (P<0.05), but no difference between group B and C (P>0.05); there were no significant difference among three groups before treatment in Harris, PAHSS and IAHSS by analysis of variance (one-way ANOVA) (P>0.05), and has significant difference at 18 months after treatment (P<0.01). There were significant difference in Harris, PAHSS and IAHSS before and after treatment at 18 months (P<0.01). LSD-t was used to analyzed the scoring of Harris, PAHSS and IAHSS, there was significant difference among group A and group B and group C (P>0.05), but no difference between group B and C (P<0.01). There were gastrointestinal reaction in 5 of group A, 35 in group B and 4 in group C.

CONCLUSIONThe effect of Xiaozhong Zhitong mixture on the prevention of heterotopic ossification after total hip arthroplasty is similar to indomethacin, but Xiaozhong Zhitong mixture has the advantages of less side effects and easily acceptance by patients.

Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; prevention & control

OBJECTIVETo evaluate the clinical efficiency of selective cyclo-oxygenase-2 (COX-2) inhibitor compared to traditional nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA).

METHODSBy searching Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Science Citation Index et al, only randomised controlled studies of selective COX-2 inhibitors VS nonselective COX-1 and COX-2 inhibitors for the prevention of HO after THA were included. The quality assessment of included studies was evaluated according to the standard of the Cochrane Collaboration, and the data were analysised by statistic software Stata 10.0. The HO incidence of both groups in different degrees was compared.

RESULTSFour eligible randomised controlled trials of totally 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR = 1.08, 95% CI: 0.71-1.64,P = 0.73), incidence of moderate severe HO (Brooker II and III) (RR = 0.83, 95% CI: 0.48-1.42, P = 0.49) and any grade of Brooker classification between two groups. In all included studies, 16 patients receiving nonselective COX inhibitor (4.4%) discontinued treatment because of gastrointestinal toxicity,whereas 10 patients in the selective COX-2 inhibitor group (2.7%) discontinued for gastrointestinal side effects.

CONCLUSIONThe selective COX-2 inhibitors are as equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the side effects of nonselective NSAIDs, selective COX-2 inhibitors were recommend for the prevention of HO after THA.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Cyclooxygenase 2 Inhibitors ; adverse effects ; therapeutic use ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Humans ; Ossification, Heterotopic ; prevention & control ; Randomized Controlled Trials as Topic

Acute pancreatitis remains the most frequent complication of endoscopic retrograde cholangiopancreatography (ERCP), with reported incidence rates that have changed little over several decades. Patient- and procedure-related risk factors for post-ERCP pancreatitis (PEP) are well-defined. Effective measures to prevent PEP have been identified, including improvements in cannulation techniques and pancreatic stenting, as well as pharmacological intervention. Pharmacotherapy has been widely studied in the prevention of PEP, but the effect in averting PEP has been inconclusive. Although pharmacological prophylaxis is appealing, attempts to find an ideal drug are incomplete. Most available data on the efficacy of pharmacological agents for PEP prophylaxis have been obtained from patients at average risk for PEP. However, recently, a randomized prospective controlled trial of rectal nonsteroidal anti-inflammatory drugs (NSAIDs) to prevent PEP in high-risk patients was published. The results revealed that rectal indomethacin reduced the incidence of PEP significantly. Thus, rectal administration of diclofenac or indomethacin immediately before or after ERCP is used routinely to prevent PEP. However, additional studies with NSAIDs using large numbers of subjects are necessary to confirm the prophylactic effect of these drugs and to establish whether they act synergistically with other prophylactic interventions, including pancreatic stenting.
Acute Disease ; Administration, Rectal ; Animals ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/*therapeutic use ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Humans ; Pancreatitis/etiology/*prevention & control ; Treatment Outcome

BACKGROUND/AIMS: We conducted this study to find the clinical characteristics of ulcer bleeding that occurred in patients who had been taking non-steroidal anti-inflammatory drugs (NSAIDs) and to evaluate the influences of NSAIDs on clinical outcomes. METHODS: Between January 2000 and December 2002, a total of 310 patients with ulcer bleeding were analyzed. Study group composed of 49 patients who had taken NSAIDs regularly for at least 4 weeks before the admission. Other 261 patients who had not taken NSAIDs were classified as control group. Relevant informations were obtained from the medical records. RESULTS: Of the NSAIDs group, aspirin was the most common medication. The mean age and the proportion of females in the NSAIDs group were significantly higher than those of the control group. Prevalence of co-morbid illness was significantly higher in the NSAIDs group than in the control group (85.7% vs 30.7%, p<0.001). The severity of bleeding which was assessed by hemoglobin level at presentation, amount of transfusion, and duration of admission, was not different between two groups. There were no significant differences in frequency of re-bleeding, urgent surgery, and mortality. CONCLUSIONS: Ulcer bleeding among patients taking NSAIDs occurred more frequently in older females with co- morbid illness. However, NSAIDs is not associated with higher morbidity and mortality.
Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/therapeutic use ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*chemically induced/complications

OBJECTIVETo study the preventive effects of jinghua weikang capsule (JWC) on nonsteroidal anti-inflammatory drugs (NSAIDs) induced injury to the mucosa of the small intestine.

METHODSThirty-two Wistar rats were randomly divided into four groups, i.e., the blank control group, the model group, the JWC group, and the esomeprazole group. Diclofenac was administered to rats in the model group, the JWC group, and the esomeprazole group at the daily dose of 15 mg/kg. JWC and esomeprazole was respectively given to those in the JWC group, and the esomeprazole group one day ahead. Normal saline was given to rats in the blank control group. Rats were killed 3 days later. The pathological changes of the small intestine were observed by hematoxylin and eosin stain.

RESULTSCompared with the blank control group, the general score for the small intestine (4.63 +/-0.52 vs 0.00 +/-0. 00) and the pathological score (4.00 +/-0.90 vs 0.00 +/-0. 00) obviously increased in the model group, showing statistical difference (P <0.05). Compared with the model group, the general score for the small intestine (1.88 +/-0.99) and the pathological score (2.11 +/-1.11) obviously decreased in the JWG group, showing statistical difference (P <0.05). Compared with the model group, the general score for the small intestine (2.75 +/-1.28) and the pathological score (2. 30 +/-0.94) obviously decreased in the esomeprazole group, showing statistical difference (P <0.05).

CONCLUSIONJWC could prevent NSAIDs induced injury to the mucosa of the small intestine.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; Diclofenac ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Esomeprazole ; pharmacology ; therapeutic use ; Intestinal Mucosa ; drug effects ; pathology ; Intestine, Small ; drug effects ; pathology ; Male ; Phytotherapy ; Rats ; Rats, Wistar

Administration, Oral ; Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Aspirin ; adverse effects ; therapeutic use ; Brain Edema ; chemically induced ; Child ; Coma ; chemically induced ; Female ; Humans ; Liver ; drug effects ; pathology ; physiopathology ; Reye Syndrome ; chemically induced ; Treatment Outcome

OBJECTIVETo observe the efficacy of Xiaoyan Zhixue Capsule (XYZXC) in treating uterus abnormal menorrhagia caused by intrauterine device (IUD) and to study its mechanism.

METHODSIUD users with menorrhagia were randomly divided into two groups, the XYZXC treated group and adrenosoem (AC-17) control group. Endometrial tissue of XYZXC treated group before and after treatment were taken out to observe its morphologic change with optic and electronic microscope. Animal experiment was done to observe the effect of XYZXC in eliminating inflammation of patierts, and the relevant parameters were monitored.

RESULTSClinical efficacy: (1) Total effective rate of the treated group was 90.3%, that of control group was 43.5%, comparison between them showed significant difference (P<0.01). (2) Morphological examination of endometrial tissue showed the inflammation in the treated group abated after treatment with the contractible function of helicine artery strengthened. Experimental study showed: (1) The auricular swelling of mice was inhibited by 40.5% in the treated group, the effect was equivalent to that of hydrocortisone (46.9%). (2) Compared with the control group, the plasma 6-keto-PGF1alpha and D-Dimer level in the treated group were markedly lower, and TXB2/6-keto-PGF1alpha ratio and plasma endothelin level were markedly higher (P<0.05 or P<0.01). ET contents in large dosage TCM group was significantly raised (P<0.05). (3) XYZXC could increase amplitude of contraction of the uterus smooth muscle as well as the uterus activity in rats in vivo.

CONCLUSIONXYZXC has obvious anti-inflammatory and hemostatic effects, it has marked effect in treating IUD caused pre- and post-menstruation menorrhagia, the possible mechanism may be: (1) Modulating the synthesis of prostaglandin; (2) Antagonizing the IUD caused fibrinolytic hyperfunction; (3) Promoting the synthesis of ET; (4) Increasing the contractility and activity of uterus smooth muscle.

Adult ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemostatics ; therapeutic use ; Humans ; Intrauterine Devices ; adverse effects ; Menorrhagia ; drug therapy ; etiology ; Mice ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Uterine Contraction ; drug effects