姝㈢负浠涔浼寮璧锋ユц捐“锛

2015骞521ャ姝ャラ锛53宀琚椋璐拱姝㈢涓ゅぉ虹ㄨ韩娴匡琚负ユц捐“绔璇ユラ寮绀句骞挎虫敞锛绉濯浣绾风悍杞浇骞舵绀哄ㄨㄣ姝㈢负浠涔浼寮ユц捐“绔濡浣垮姝ょ被浜浠跺

浠涔

界惰肩绉淇ゆу搴锛瀹浠绀哄苟绀鸿绂讳激瀹虫у遍┿浣肩绉涓锛骞朵即躲绛璐㈡缁搴锛涓ラ剁虫句互蹇讹肩变浜轰搴婵搴寮澶瀹炽姝わや浜轰婧х肩璋哄跺浠ュ瀵逛肩у锛瀵逛腑搴互涓肩锛浜轰滑寰寰瑕姹╀╃甯╂ョ瑙ｇ肩

涓村涓锛℃ㄤ肩烘淇″褰㈡浼瀵笺肩褰㈡浠ュ婧ц哄跺涓姘肩缂瑙ｄㄧ╃绉颁负姝㈢

姝㈢绫

甯哥ㄧ姝㈢涓ょ被涓绫绘瀵瑰己肩楹婚ф杩绫昏杩妯℃浣ㄤ肩婧ф剁郴缁ヤ甯哥ㄧ濡楦°蜂绛杩绫绘富瑕浣ㄤ腑㈢缁郴缁锛锋楹婚渚璧э姝ゅ浜寰寮哄剁姣楹昏╋涓村浣跨ㄥ版澶ч躲

涓绫绘璁烘婧х╄川绫绘浼ら戒寮搴锛ㄥ搴杩绋涓绉浠璐ㄩ藉浠ラ杩澶ㄦ涓㈤寰烘浜х肩杩舵娑ょ搴锛绘浠璐ㄧ浜х浣ㄧ╄川峰浠ヨ捣扮瑙ｇ肩浣杩绫昏╄绉颁负娑

娑规瀛宸涓轰袱绫伙涓绫绘句虹川婵绱锛涔绉扮川婵绱╋浠ラ杩剁搴锛朵浠ラ杩婧ф绯荤ョ瑙ｇ肩锛娑涓鸿绫昏╁浜句绫绘绱锛姝や绉颁负句绫绘

稿锛朵涓句缁锛锋娑浣ㄧ╃绉颁负句绫绘non-steroidal anti-inflammatory drugs锛NSAIDs锛NSAIDs复搴涓浣跨ㄦ涓哄箍娉╋涔灏辨汉浠父璇寸姝㈢

у瀛锛NSAIDs涓鸿澶绉绫汇濡锛查哥被锛涔绉版按ㄩ哥被锛浠ｈ〃╀负垮规锛′哥被锛浠ｈ〃╀负姘搞插缇锛娑锛绛锛哥被锛浠ｈ〃╀负甯娲绛锛ｆ搴风被锛＄搴枫缇搴风锛ゆ甯绫伙濉ユ甯缃甯绛锛ュ″被涔杩姘ㄥ烘淇娉版俱缇哄浠跺锛濡灏肩┿

澶锛骞虫瑙ｇ浠ラ杩缂瑙ｅ钩婊х肩锛楠ㄩ惧浠ョ瑙ｈ绱ух肩锛浠ョ瑙ｆ浜肩浣杩浜绫讳戒哥姝㈢

NSAIDs娑浣ㄦ哄

虹(PG)绉瑕浠璐浠瀵肩搴涓肩虹卞ㄤ涓涓绉琚О涓鸿辩哥璐ㄧ被╄川杞ワ姘у(COX)涓浆杩绋涓抽躲NSAIDs灏辨杩COXュPGユ姝㈢ㄧ

澶锛NSAIDs杩浠ユ剁７镐剁娲绘э杩剁７镐讹ADR锛绋冲婧堕朵婧堕朵撅浠剁搴

NSAIDs姣ф哄

涓涓绾90骞翠唬绌跺姘у舵涓ょ宸ラCOX-1COX-2COX-1讹瀛ㄤ绠°剧姝ｅ父缁缁涓涓昏浠瀵肩у虹绫荤╄川褰㈡COX-2瀵奸讹ㄧх瀛烘涓澶ч锛涓昏瀛ㄤㄤ锛淇浣夸涓虹т璐ㄥ虹绫荤╄川

姝ｅ父缁缁涓虹璁稿瑕斤╁ㄨ锛璋捐娴锛浣胯炬护杩澧锛淇杩娉锛浣锛惰稿娉锛浣垮瀹绾ょ淮剁缉锛婧惰В榛浣锛寮姘绠″钩婊锛浣块蓟绮琛绠℃剁缉锛惰灏胯绛

NSAIDs剁缁缁虹ユㄥ讹娌℃╃舵甯哥缁虹瀵艰寸郴ㄤ骇锛绐鸿〃ㄨ涓捐袱归

NSAIDsユц炬浼

NSAIDsユц炬浼ゆ复搴甯歌╀搴涔涓锛澶板浠ュㄥ㈠锛灏板浠ラ涓ラ炬瀹筹虫浜°

哄

NSAIDs瀵艰翠袱绉涓绫诲ユц炬浼ゃ

1. 琛娑插ㄥ瀛瀵肩ユц炬浼わ濡惧浼ゅ/ユц惧虹浠ユ╁惧ョ灏ㄨ锛澧捐琛娑茬娉ㄩ惧婊よ锛瀵逛淮よ捐娑蹭搴捐护杩藉冲抽瑕

NSAIDs杩瀵COX堕浣PG浜х锛瀵艰磋捐娑茬娴惧婊よ浣ユц惧藉缁瀹筹涓ラ剁冲浠ュ磋惧杩绉朵ㄦ锛姣ㄧ浜х涓搴稿炽姝わ姣ㄩ甯稿COX娲绘ц揪版澶ф剁琛娴娴搴ǔ锛涓3-7澶┿

2. 瀵肩ユц炬浼わ濡ユч磋川ц剧杩涓娓妤NSAIDs瀵艰存ユч磋川ц剧纭哄躲宸茬浜烘猴COX跺璧风辩镐杞涓虹戒浠瑙韩у搴

遍╁绱

浠杩板哄跺瑙锛NSAIDsユц炬瀹充富瑕变COX跺村虹惧磋捐娑茬娴惧婊よ浣淬姝ｅ父浜猴ㄧ舵涓锛ㄦ甯稿NSAIDs甯告ㄧ锛浜绱褰卞炬浼ょ遍╋

1. 骞撮锛骞撮澧锛灏ゅ舵勾榫>65锛锛㈡ч琛ㄨ绮ユ风‖绛跺靛氨村捐娑茬娉濡舵NSAIDs寰寰浣瀵艰磋炬瀹崇ㄦ拌タ颁椤瑰ぇ涓村绌朵腑锛74%NSAIDsユц炬浼ゅ65宀浠ヤ骞翠汉

2. 捐介纰锛濡ㄨ惧剧惧戒NSAIDs捐澧捐瀹崇椋┿

3. 琛瀹归瓒筹璁烘恫浣ヤ瓒筹浣娑蹭涪澶卞锛涓ラ规郴绛娑涓㈠け锛杩捐ぇ按佃В璐ㄤ涪澶憋澶ч烘瀵艰存按涓㈠け锛澶辫锛浣跨ㄥ╁翱绛锛锛浠ュ纭蹇“绔琛瀹归瓒冲浠ュ奖捐娉NSAIDs瀹抽┿

4. ╋绠＄揣寮绱杞㈤讹ACE锛跺琛绠＄揣寮绱II浣锛ARB锛╁翱父ㄧ楂琛╋藉浠ュ澧NSAIDsユц炬浼ら┿

5.涓烩锛triple whammy锛锛涓村涓濡ACE跺ARB涓╁翱锛ㄥ涓NSAIDs浣跨灏捐澧NSAIDs捐瀹抽╋琚О涓哄浜捐涓烩

6. NSAIDs杩澶浣跨 NSAIDs瀵逛COX舵ㄦ骞宠　杩绋锛涓绉绫荤NSAIDs瀵逛COX跺己搴缁存堕翠锛NSAIDs父ㄧ╃父浠ュ澶瑰舰寮ㄤ绉╀腑锛浜轰滑寰寰涓轰杩芥蹇楂姝㈢涓拌澶浣跨NSAIDs锛瀹规COX杩搴惰澧捐瀹抽┿

濡浣棰NSAIDsユц炬浼わ

姝ｇ‘璁よNSAIDs跺捐浼ゆ哄跺遍╁绱锛褰斤NSAIDsユц炬浼ゆ浠ラ茬

1. 涓杩搴杩娇ㄩ澶规濡ㄤ杩缁娇ㄨ杩10澶╋ㄤ杩涓澶╃芥讹涓藉缁х画浣跨ㄨ绫昏╋搴璇ラ╁氨汇

2. 垮挎堕翠娇ㄥ姝㈢澶硅╋寰澶姝㈢互澶瑰舰寮寰澶朵澶瑰跺涓缁父杩绫绘╋濡垮规瀵逛版皑洪″绛娣峰瀛姝ら瑕‘╂锛垮挎杩缁娇ㄣ

3. ㄦ跺娑蹭ワ缁存琛瀹归浠ヤ璇捐娉ㄥ惧婊よ锛╀垮炬瀹崇甯告ぉ瑕6-81500~2000姣锛姘村锛澶чㄥ烘舵村璇ユ规绠躲瓒抽ˉ姘村

4. ㄦ搴垮楗涔舵╁翱婵绱浜х撅锋╁翱浣ㄣ杩绫昏捐瀹崇哄朵涓灏辨惰惧虹浜х锛浠褰卞惧ョㄨ锛惧芥ц绠★╁锛瀵艰磋剧娴惧婊よ稿浜ㄦ轰娌归浣村惧斤涓ラ浜浠ラ惧捐“浠讳╁翱姘翠瓒抽戒杩涓绋

5. 濡ㄨ捐剧锛搴垮ㄦ濡蹇椤绘ㄩ瑕ㄨ荤锛ㄥ荤瀵间ㄨ

6. 濡瀛ㄥ楂琛捐剧剧锛姝ｅㄦㄥ╁翱╋骞撮瓒杩65宀锛蹇椤绘NSAIDs锛瑕ㄥ荤瀵间杩琛

7. ｆ韩ц剧ｈ搴瀹ㄩ垮NSAIDs

8. 浣跨ㄤ换浣澶规锛璇昏璇存功涓璀绛俱