| Objective:To observe the clinical effect of rosiglitazone in patients with type 2diabetes complicated with acute gouty arthritis,and to evaluate its safety.Explore the possibility of its use in the treatment or adjuvant treatment of gouty arthritis.Method:58 patients with type 2 diabetes complicated with acute gouty arthritis who were meeting diagnostic and inclusion criteria were randomly divided into the control group(29 cases)and the rosiglitazone observation group(29 cases).The control group were given metformin(Gehua Zhi)0.5g thrice a day;colchicine 0.5mg,twice a day,even for 3 days,then changed to 0.5mg,once a day;sodium bicarbonate 1.0g thrice a day,etoricoxib(Ankang xin)60 mg once a day.The observation group was given rosiglitazone tablets on the basis of the control group 4 mgonce a day.The two groups were treated continuously for 2 week.The scores of joint tenderness,swelling degree and VAS score before and after treatment were compared between the two groups.The clinical efficacy of each group was compared.The laboratory indicators were compared before and after treatment: blood WBC count,C-reactive protein(CRP),blood cell sedimentation rate(ESR),Serum uric acid(SUA),glucose(GLU),triglyceride(TG),total cholesterol(TC),glutamic alanine aminotransferase(ALT),glutamic aspartate aminotransferase(AST),serum creatinine(SCr),urea nitrogen(BUN),and other indicators.Result:(1)Baseline indexes between the two groups has no significant difference(P>0.05).(2)Comparison of the efficacy of the two groups of patients:The total effective rate was 93.10% in the observation group and 89.66% in the control group.There was no significant difference(P>0.05).However,the pain relief time of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).(3)Before treatment,joint swelling,tenderness and pain VAS score between the two groups were no significant differences(P>0.05).After treatment,the joint swelling and VAS scores of the two groups were significantly lower than those before treatment (P<0.05),and the degree of the observation group was more obvious than that of the control group(P<0.05).However,there was no significant difference between the two groups in improving joint tenderness(P>0.05).(4)Before treatment,serum uric acid levels between the two groups were no significant difference(P>0.05).After treatment,serum uric acid levels were lower in both groups than before treatment(P<0.05),and the degree of reduce serum uric acid level in the observation group was significant than that in the control group(P<0.05).(5)Before treatment,the blood glucose,blood lipid(total cholesterol,triglyceride)levels in the two groups were not significantly different(P>0.05).After treatment,the blood glucose and blood lipid levels of the two groups were lower than before(P<0.05).The observation group was significantly better than the control group in reducing blood lipid levels(P>0.05).(6)After treatment,the incidence of adverse reactions in the observation group was17.24%,and that in the control group was 20.69%.There was no significant difference(P>0.05).Conclusion:(1)Thiazolidinediones hypoglycemic agents combined with colchicine in patients with type 2 diabetes complicated with acute gouty arthritis have significant clinical efficacy compared with Metformin combined with colchicine alone.(2)Thiazolidinedione hypoglycemic agents can not only lower blood glucose,but also reduce uric acid,inflammation index,VAS score,clinical symptom scores and blood lipid levels in patients with acute gouty arthritis.It is beneficial for the clinical application of patients with diabetes complicated with gout,even patients with metabolic diseases.(3)Thiazolidinediones deserves to be popularized and becomes an good treatment of type 2 diabetes with acute gouty arthritis since its security and effectiveness.and can be used as an effective drug for adjuvant therapy. |
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