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

OBJECTIVETo investigate the quality of life in patients with gout and their influencing factors, and to observe the effects of the intervention program of stage-based treatment of integrative medicine (IM).

METHODSTotally 120 patients with acute attack of gout within 72 h were randomly assigned to the treatment group and the control group, 60 in each group. Patients in the treatment group were treated with Huzhang Tongfeng Granule (HTG), diclofenac sodium extended-release capsule and Jinhuang Ointment (JO) in the acute stage, and Yinlian Tongfeng Granule (YTG) and Benzbromarone Tablet (BT) in the intermission stage. Patients in the control group were treated with diclofenac sodium extended-release capsule in the acute stage, and BT in the intermission stage. All patients were treated for 12 weeks. The quality of life (QOL) before and after treatment was investigated by questionnaire.

RESULTSBefore treatment there were no statistical difference in the physiological function, psychological function, social function, health self-awareness and total score between the two groups (P > 0.05). After treatment the scores of the four aspects and the total score were significantly improved in the two groups (P < 0.01). And the improvement of the treatment group was better than that of the control group (P < 0.01). There was no statistical difference in the gender, age, marital status, educational level, QOL with or without associated disease between the two groups (P > 0.05). The QOL of patients with joint stiffness or deformity was less than that of those without joint stiffness or deformity (P < 0.01). The total QOL scores of the gout patients were obviously correlated with the course of diseases (r = -0.324, P < 0.01).

CONCLUSIONSThe QOL of patients with gout was correlated with the course of disease and joint stiffness or deformity. Stage-based treatment of IM could significantly improve the QOL of f out patients.

Adult ; Aged ; Aged, 80 and over ; Benzbromarone ; therapeutic use ; Diclofenac ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gout ; prevention & control ; therapy ; Humans ; Integrative Medicine ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Universal Precautions

OBJECTIVETo investigate the change of T-lymphocyte subsets in peripheral blood of rheumatoid arthritis (RA) patients and analyze the effects of Fuzheng Qubi Decoction (FZQBD) on T-cell subsets.

METHODSThirty RA patients were randomly divided into two groups, and treated with FZQBD or western medicine combination therapy respectively for one month, the percentage of peripheral CD3+, CD4+, CD8+ as well as the serum IgG and IgA levels were determined.

RESULTSThe percentage of peripheral CD4+, CD4+/CD8+ ratio, IgG and IgA levels increased significantly (P < 0.001) in RA patients before treatment. After 1 month of FZQBD treatment, the CD4+/CD8+ ratio decreased obviously (P < 0.05).

CONCLUSIONAbnormal cellular immunity exists in RA patients, FZQBD could adjust the abnormal T-lymphocyte subsets to normalize it.

Adolescent ; Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; immunology ; CD4-CD8 Ratio ; Diclofenac ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocyte Subsets ; immunology

Overexpression of cyclooxygenase-2 (COX-2) has been associated with hepatocarcinogenesis. Inhibitors of COX-2 have proapoptotic and antiproliferative effects on malignant tumors and inhibit tumor invasion to the surrounding tissues. We report here a case of complete regression of advanced hepatocellular carcinoma (HCC) during COX-2 inhibitor administration. An eighty-year-old female was diagnosed as an advanced HCC, which was associated with HCV infection. She received COX-2 inhibitor for 3 months due to degenerative arthritis of both knees. Tumor enhancement on arterial phase CT completely disappeared without specific treatment for the HCC, and the tumor size decreased on the follow-up CT scan.
Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Hepatocellular/*drug therapy ; Cyclooxygenase 2 Inhibitors/administration & dosage/*therapeutic use ; Diclofenac/administration & dosage/analogs & derivatives/therapeutic use ; Female ; Humans ; Lactones/administration & dosage/therapeutic use ; Liver Neoplasms/*drug therapy ; Pyrazoles/administration & dosage/therapeutic use ; Sulfonamides/administration & dosage/therapeutic use ; Sulfones/administration & dosage/therapeutic use

PURPOSE: The aim of this study is to explore non-steroid anti-inflammation drugs (NSAIDs) potency for pelvic floor muscle pain by measuring local concentration in a rat model. MATERIALS AND METHODS: We used nine NSAIDs, including nabumetone, naproxen, ibuprofen, meloxicam, piroxicam, diclofenac potassium, etodolac, indomethacin, and sulindac, and 9 groups of female Wister rats. Each group of rats was fed with one kind of NSAID (2 mg/mL) for three consecutive days. Thereafter, one mL of blood and one gram of pelvic floor muscle were taken to measure drug pharmacokinetics, including partition coefficient, lipophilicity, elimination of half-life (T1/2) and muscle/plasma converting ratio (Css, muscle/Css, plasma). RESULTS: Diclofenac potassium had the lowest T1/2 and the highest mean Css, muscle/Css, plasma (1.9 hours and 0.85+/-0.53, respectively). The mean Css, muscle/Css, plasma of sulindac, naproxen and ibuprofen were lower than other experimental NSAIDs. CONCLUSION: Diclofenac potassium had the highest disposition in pelvic floor muscle in a rat model. The finding implies that diclofenac potassium might be the choice for pain relief in pelvic muscle.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Butanones/therapeutic use ; Chronic Pain/*drug therapy ; Diclofenac/therapeutic use ; Female ; Muscles/drug effects ; Naproxen/therapeutic use ; Pelvic Floor/*pathology ; Pelvic Pain/*drug therapy ; Piroxicam/therapeutic use ; Rats ; Rats, Wistar ; Thiazines/therapeutic use ; Thiazoles/therapeutic use

OBJECTIVETo study the therapeutic effect and possible mechanism of total panax notoginseng saponins (PNS) for treatment of rheumatoid arthritis (RA), and to observe its safety and influence on RA immune related inner environment.

METHODSEighty-four patients were randomly assigned to two groups. All were treated with the routine therapy with diclofenac sodium, Leflunomide and prednisone, but for the 43 patients in the treatment group PNS was given additionally. The therapeutic course was 28 days for both groups. Clinical efficacy and change of indexes including platelet counts, immnuoglobulins (IgG, IgA, IgM), complement (C)3, rheumatoid factor (RF), C-reactive protein (CRP), ceruloplasmin (CER), haptoglobin (HPT), and alpha1-acid glycoprotein (AAG) were observed.

RESULTSSignificant improvement of clinical symptoms, including the joint swelling index, joint tenderness index, joint pain index, time of morning stiffness and VAS revealed in both groups after treatment, and the effect in the treatment group was better (P<0.05 or P<0.01). PLT, CER, AAG, HPT, CRP, IgG, IgA, IgM, C3 and RF were lowered in both groups (P<0.01), but the lowering in PLT, CER, AAG and CRP in the treatment group was more significant than that in the control group respectively (P < 0.05 or P < 0.01).

CONCLUSIONPNS can significantly improve the condition of patients, enhance the therapeutic effect in treating RA, through regulating the disordered immunity and improving the effect of anti-inflammatory and analgesia.

Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; immunology ; Diclofenac ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Isoxazoles ; therapeutic use ; Male ; Middle Aged ; Panax notoginseng ; chemistry ; Phytotherapy ; Prednisone ; therapeutic use ; Rheumatoid Factor ; blood ; Saponins ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the therapeutic efficacy and safety of Gubitong Recipe (, GBT) in treating osteoarthritis (OA) of knee joint.

METHODSNinety patients with knee osteoarthritis were equally assigned, according to a randomizing digital table, to the treatment group and the control group. The treatment group was treated with GBT Decoction one dose every day and the control group with glucosamine sulfate 500 mg thrice a day, respectively, for eight successive weeks. Besides, diclofenac sodium could be given as supplementary dugs with the dosage used recorded if necessary. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, an index reflecting the degree of joint pain, stiffness, and dysfunction) in patients was assessed before and after treatment, and the patients' symptoms were evaluated by visual analogue scale (VAS) as well. Moreover, erythrocyte sedimentation rate (ESR), blood C-reactive protein (CRP), blood and urinary routine tests, liver and kidney function examination, and the adverse reaction that occurred during the treatment period were observed.

RESULTSWOMAC index and integral VAS value were lowered in both groups after treatment, showing significant statistical difference as compared with before treatment (P<0.05), but the decrement of WOMAC index in the treatment group was more significant than that in the control group (P<0.05). ESR and CRP levels remained unchanged in all patients, and the proportion and mean dosage of diclofenac sodium used were similar in the two groups. No evident adverse reaction occurred during the treatment period.

CONCLUSIONGBT is an effective and safe recipe for the treatment of osteoarthritis of knee joint, which could alleviate the joint pain, stiffness, and dysfunction.

Adult ; Aged ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Diclofenac ; therapeutic use ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Osteoarthritis, Knee ; blood ; drug therapy ; Pain Measurement

OBJECTIVETo observe the differences of effect of electroacupuncture and medication on hip osteoarthritis.

METHODSSixty cases were randomly divided into an electroacupuncture group and a medication group, 30 cases in each one. In electroacupuncture group, electroacupuncture was applied at Biguan (ST 31), Juliao (GB 29), Zuwuli (LR 10) and Yinlian (LR 11). In medication group, Diclofenac Sodium was prescribed for oral administration. One month after treatment, Visual Analogue Scale (VAS) and Harris score were compared between two groups.

RESULTSVAS scores were 67.83 +/- 8.48 and 55.83 +/- 9.66 before and after treatment in electroacupuncture group, and were 68.67 +/- 8.09 and 61.50 +/- 7.78 in medication group separately. VAS pain scores after treatment were reduced remarkably in two groups (both P < 0.001), but the score was reduced much more remarkably in electroacupuncture group as compared with medication group. In electroacupuncture group, after treatment, Harris total score, the single scores of joint pain, function and motion range increased apparently as compared with those before treatment (all P < 0.001). In medication group, after treatment, Harris total score and pain score increased remarkably as compared with those before treatment (both P < 0.001). Harris total score, pain score and function score after treatment in electroacupuncture group increased much more remarkably as compared with those in medication group (all P < 0.05).

CONCLUSIONElectroacupuncture can treat effectively hip osteoarthritis, relieve joint pain and improve joint function. The efficacy of it is superior to that of oral administration of Diclofenac Sodium.

Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Diclofenac ; therapeutic use ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Hip ; drug therapy ; therapy ; Pain ; drug therapy ; Pain Management ; Treatment Outcome

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

OBJECTIVETo investigate therapeutic effects of stiletto needle and Dichofenac Diethylammon in treating knee osteoarthritis pain at early and medium-term.

METHODSSixty-seven patients with early and medium-term knee osteoarthritis were randomly divided into two groups, 34 cases in stiletto needle group (treatment group) and 33 cases in Dichofenac Diethylammon (control group). Among them, 60 patients finished treatment and followed-up for 1 months (7 cases fall off totally, 4 cases in treatment group and 3 cases in control group). In treatment group, there were 5 males and 25 females with a mean age of (55.90 +/- 9.34) years (ranged, 40 to 68 years), the course of disease for 0.25 to 1 year, mean (0.87 +/- 0.34) years, treated by stiletto needle once a week, and 3 weeks were a course. In control group, there were 6 males and 24 females with a mean age of (58.67 +/- 7.39) years (ranged, 40 to 70 years), the course of disease for 0.25 to 2 years, mean (0.93 +/- 0.60) years, treated by Dichofenac Diethylammon, three times a day for 3 weeks. Soft tissue displacement and banana area were tested by soft tissue tension tester, pressure value were measured by pressure measuring instrument, VAS score were recorded by pain visual analog scale record, HSS scoring and effects were used to evaluated and statistical analyzed.

RESULTSThere were significant differences in tissue displacement, banana area, pressure value, VAS scoring and HSS scoring between two groups before and after treatment, and tissue displacement, pressure value, HSS scoring in treatment group were higher than control group, while banana area and VAS scoring were lower than control group. According to HSS scoring and VAS scoring, 3 cases were healed, 8 cases were markedly improved, 18 cases were effective and 1 case was effectiveless in treatment group;while 1 case was healed, 4 cases were markedly improved, 20 cases were effective and 5 cases were effectiveless in control group. There was no significant meaning in therapeutic effects.

CONCLUSIONStiletto needle for knee osteoarthritis pain can effectively reduce high tension of local soft tissue ,alleviate symptom of pain, and improve knee function.

Adult ; Aged ; Biomechanical Phenomena ; Case-Control Studies ; Diclofenac ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Needles ; Osteoarthritis, Knee ; complications ; Pain ; complications ; drug therapy ; pathology ; physiopathology ; Pain Management ; methods ; Treatment Outcome