2012 ACR 关于手部、髋部和膝部骨关节炎的非药物和药物治疗的建议
2012年美国风湿病学会(ACR)更新了2000年制定的关于膝和髋骨关节炎的治疗指南,并发布了手骨关节炎治疗的新的推荐方案。此次修改主要以文献证据和专家共识为依据,在权衡药物与非药物治疗利弊的基础上制定出不同证据级别的治疗方案。该指南指出,临床医生在选择治疗方案时,对于选择同等级证据的建议并不存在先后原则,应该结合患者基础健康状况选择最佳方案。本次更新意见对于膝和髋骨关节炎患者,强调了长期应用非甾体抗炎药(NSAIDs)的同时应服用质子泵抑制剂(PPI)降低其胃肠道的不良反应;对于推荐的药物及非药物治疗不满意且不愿意接受手术的患者可以应用阿片类止痛剂。由于北美很少采用药物治疗骨关节炎,因此指南没有强烈推荐药物治疗;同样,该指南对于手术治疗并未提出指导意见。
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The American College of Rheumatology's mission is advancing rheumatology. The organization is for physicians, health professionals, and scientists that meets the mission through programs of education, research, advocacy and practice support. The ACR provides professional education for its members through several venues. The Annual Scientific Meeting, held each fall, is the premier scientific meeting devoted to the rheumatic diseases. This meeting draws thousands of rheumatologists and arthritis health professionals from around the world. A winter rheumatology symposium, spring clinical meetings, and other topical conferences round out the ACR's educational offerings.