Drugs Aging:骨关节炎老年患者用止痛药维持活动能力可行吗?

2017-06-22 闫盈盈 石岩 环球医学

2017年6月,发表在《Drugs Aging》的一项由澳大利亚科学家进行的综述,考察了骨关节炎老人继续使用止痛药以维持活动能力是否可行。骨关节炎是老年人常见的进行性疾病,受影响的患者往往身体功能受损、处于共病状态且生活质量降低。在骨关节炎患者中,疼痛被报告为活动受限的主要原因,指南建议将药物和非药物策略相结合来进行疼痛管理。锻炼对骨关节炎管理的益处已经确立;然而,疼痛是患者参与并坚持活动计划的最

2017年6月,发表在《Drugs Aging》的一项由澳大利亚科学家进行的综述,考察了骨关节炎老人继续使用止痛药以维持活动能力是否可行。

骨关节炎是老年人常见的进行性疾病,受影响的患者往往身体功能受损、处于共病状态且生活质量降低。在骨关节炎患者中,疼痛被报告为活动受限的主要原因,指南建议将药物和非药物策略相结合来进行疼痛管理。锻炼对骨关节炎管理的益处已经确立;然而,疼痛是患者参与并坚持活动计划的最大障碍。目前,人们对止痛药使用的态度大相径庭,并且缺少有效性或害怕副作用可能导致治疗剂量不足。此外,短期使用扑热息痛对骨关节炎患者无效的综述也增加了人们的困惑。本综述考察了当前药物使用的局限性,总结了患者对骨关节炎疼痛使用止痛药的态度(重点关注了扑热息痛),探讨了身体活动对骨关节炎管理的作用。

证据表明,尽管有明确的指南,但对骨关节炎的症状一般管理较差。需要更多研究通过优化药物治疗方案,考察骨关节炎患者的临床结局,来更好地了解长期使用止痛药结合身体活动能否帮助患者战胜活动受限。

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    2018-02-10 爆笑小医
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    2017-12-16 tsing_hit
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    2017-10-13 lisa438
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GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
  5. 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objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), 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  6. 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channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jun 24 12:44:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214287, encodeId=5ac621428e40, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Jun 23 08:21:20 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214252, encodeId=f2e1214252dc, content=学习了。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
    2017-06-24 lmm397
  7. 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encryptionId=597b631634d, topicName=止痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8da42553722, createdName=zhangxingru, createdTime=Sat Jun 24 12:44:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289968, encodeId=e5cd12899686f, content=<a href='/topic/show?id=50e36316e7d' target=_blank style='color:#2F92EE;'>#止痛药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63167, encryptionId=50e36316e7d, topicName=止痛药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f32220, createdName=lancelotzzl, createdTime=Sat Jun 24 12:44:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265447, encodeId=33b5126544efa, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, 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objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
    2017-06-23 明月清辉

    谢谢分享,学习了

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
    2017-06-23 1dd7a091m35(暂无匿称)

    学习了。。。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1862252, encodeId=079e1862252e1, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sat Feb 10 13:44:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784754, encodeId=688b1e8475415, content=<a href='/topic/show?id=e451626993' target=_blank style='color:#2F92EE;'>#drugs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6269, encryptionId=e451626993, topicName=drugs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dcaa509, 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channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jun 24 12:44:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214287, encodeId=5ac621428e40, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Jun 23 08:21:20 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214252, encodeId=f2e1214252dc, content=学习了。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
    2017-06-23 我是谁??

    学习了。。。。

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1862252, encodeId=079e1862252e1, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sat Feb 10 13:44:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784754, encodeId=688b1e8475415, content=<a href='/topic/show?id=e451626993' target=_blank style='color:#2F92EE;'>#drugs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6269, encryptionId=e451626993, topicName=drugs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dcaa509, 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channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jun 24 12:44:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214287, encodeId=5ac621428e40, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Jun 23 08:21:20 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214252, encodeId=f2e1214252dc, content=学习了。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Fri Jun 23 07:55:26 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214222, encodeId=f2a1214222bc, content=学习了。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Fri Jun 23 07:42:49 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214193, encodeId=d0da21419354, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Fri Jun 23 07:20:44 CST 2017, time=2017-06-23, status=1, ipAttribution=)]
    2017-06-23 189****1577

    值得推荐一下

    0

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使用20米步行测试评估12个月内的速度变化可能有助于识别在随后的24个月内发展rKOA风险增加的个体。

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目前,关于骨关节炎(OA)的发病机制知之甚少,对其治疗方法也仅限于预防疾病发展。最近的研究表明,外来体在细胞间细胞传播和许多年龄相关疾病的发病机理中起重要作用。滑膜衍生的外来miRNAs的分子分析可能增加我们对OA进展的理解,并可能导致发现新的生物标志物和治疗靶点。

Arthritis Rheumatol:血尿酸水平能够预测骨关节炎的关节腔狭窄

在非痛风性膝关节OA患者中,血清UA水平可以预测将来的JSN,并可作为OA进展的生物标志物。

Arthritis Rheumatol:代谢综合征及其组分与骨关节炎:弗雷明汉骨关节炎研究

根据BMI调整后,代谢综合征及其组分均与偶发OA无关联。OA和高血压之间可能存在关联,仍需要进一步研究。

Arthritis Rheumatol:症状性手部骨关节炎的终生风险

症状性手部OA整体对社会人口学和临床亚组的巨大负担。需要更多地利用公共卫生和临床干预来解决其影响。

J Rheumatol:骨关节炎初步MRI评分的发展及可靠性

在评估总体特征得分时,这个初步的FOAMRIS证明了良好的同一阅片者可靠性和良好的阅片者间的可靠性。