{"id":605,"date":"2015-11-01T15:56:47","date_gmt":"2015-11-01T07:56:47","guid":{"rendered":"http:\/\/epaper.pch.org.tw\/?p=605"},"modified":"2015-11-02T09:51:04","modified_gmt":"2015-11-02T01:51:04","slug":"%e7%97%9b%e9%a2%a8%e4%b9%8b%e8%97%a5%e7%89%a9%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"http:\/\/epaper.pch.org.tw\/?p=605","title":{"rendered":"\u75db\u98a8\u4e4b\u85e5\u7269\u6cbb\u7642"},"content":{"rendered":"

\u25a0 \u85e5\u5291\u79d1 \u5433\u5c1a\u502b \u85e5\u5e2b<\/p>\n

\u75db\u98a8\u53ef\u4ee5\u8aaa\u662f\u73fe\u4ee3\u4eba\u7684\u6587\u660e\u75c5\uff0c\u5b83\u662f\u56e0\u8840\u4e2d\uf9bd\u9178\u6fc3\ufa01\u904e\u9ad8\uff0c\u5f15\u8d77\uf9bd\u9178\u9209\u9e7d\u7d50\u6676\u6c89\u7a4d\u65bc\u95dc\u7bc0\u3001\u8edf\u9aa8\u3001\uf904\u56ca\u6db2\u3001\u808c\u8171\u6216\u8edf\u7d44\u7e54\u4e2d\u7684\u4e00\u7a2e\u767c\u708e\u6027\u75be\u75c5\u3002\u96d6\u7136\u9ad8\u5c3f\u9178\u75c7\u662f\u75db\u98a8\u5f62\u6210\u7684\u57fa\u790e\uff0c\u4f46\u7576\u53ea\u767c\u751f\u9ad8\u5c3f\u9178\u75c7\u6642\u5e38\u5e38\u662f\u7121\u75c7\u72c0\u7684\uff0c\u4ee5\u4e0b\u4ecb\u7d39\u6cbb\u7642\u65b9\u6cd5\u3002<\/p>\n

\u6025\u6027\u75db\u98a8\u95dc\u7bc0\u708e\u4e4b\u85e5\u7269\u6cbb\u7642<\/strong>
\n1. \u9996\u9078\u85e5\u7269- \u975e\u985e\u56fa\u9187\u6297\u767c\u708e\u85e5\u7269\uff08NSAIDs\uff09
\n\u4e00\u822c\u4f7f\u7528\u975e\uf9d0\u56fa\u9187\u6d88\u708e\u6b62\u75db\u85e5\u7269\u572824 \u5c0f\u6642\u5167\uff0c\u75bc\u75db\u75c7\uf9fa\u53ef\u4ee5\u5f88\u660e\u986f\u7684\u7372\u5f97\u6e1b\u7de9\u3002\u6cbb\u7642\u61c9\u5728\u75c7\u72c0\u51fa\u73fe\u4e00\u958b\u59cb\u7d66\u4e88\u6700\u5927\u7684\u5291\u91cf\uff0c\u4e26\u5728\u6025\u6027\u767c\u4f5c\u5b8c\u6574\u7684\u75c5\u7406\u75c7\u72c0\u6d88\u9000\u5f8c\u6301\u7e8c\u7d66\u4e8824 \u5c0f\u6642\uff0c\u7136\u5f8c\u57282 \uff5e 3 \u5929\u5feb\u901f\u6e1b\u91cf\u3002\u4e00\u822c\u5728\u958b\u59cb\u6cbb\u7642\u5f8c\u76845 \uff5e 8 \u5929\u5167\uff0c\u5927\u591a\u60a3\u8005\u6025\u6027\u767c\u4f5c\u7684\u75c5\u7406\u75c7\u72c0\u6703\u51fa\u73fe\u6d88\u9000\u7684\u73fe\u8c61\u3002<\/p>\n

2. \u79cb\u6c34\u4ed9\u9e7c-Colchicines
\n\u5728\u6025\u6027\u75db\u98a8\u767c\u4f5c\u671f\u9593\u79cb\u6c34\u4ed9\u7d200.5 mg \u65e9\u665a\u5404\u4e00\uf9f9\u52a0\u4e0a\u975e\uf9d0\u56fa\u9187\u6d88\u708e\u6b62\u75db\u85e5\u5408\u4f75\u4f7f\u7528\uff1b\u6216\u6709\u767c\u4f5c\u9810\u611f\u6642\uff0c\u5728\u524d3 \u500b\u5c0f\u6642\u6bcf\u5c0f\u6642\u7d660.5 mg\uff0c\u7e3d\u51713 \u52306 \uf9f9\u70ba\u6b62\u3002<\/p>\n

3. \u76ae\u8cea\u985e\u56fa\u9187\uff08Corticosteroids\uff09
\n\u76ae\u8cea\u985e\u56fa\u9187\u53ef\u7528\u65bc\u6cbb\u7642\u75db\u98a8\u6027\u95dc\u7bc0\u708e\u7684\u6025\u6027\u767c\u4f5c\uff0c\u4f46\u5b83\u5011\u4e3b\u8981\u4fdd\u7559\u7d66NSAID\u6216Colchicine \u6cbb\u7642\u6709\u7981\u5fcc\u75c7\u6216\u6c92\u6709\u53cd\u61c9\u7684\u60a3\u8005\u4f7f\u7528\u3002\u6d89\u53ca\u591a\u95dc\u7bc0\u7684\u60a3\u8005\u53ef\u4f7f\u7528\u53e3\u670d\u7684prednisone(Compesolon\u00ae)30-60mg\/ \u5929\uff1b \u95dc\u7bc0\u5167triamcinolone\u00a0acetonide(SHINCORT\u00ae ) \u53ef\u6709\u6548\u6cbb\u7642\u50c5\u9650\u65bc\u4e00\u6216\u5169\u500b\u95dc\u7bc0\u7684\u6025\u6027\u75db\u98a8\uff1b\u5982\u679c\u60a3\u8005\u7121\u6cd5\u4f7f\u7528\u53e3\u670d\u6cbb\u7642\uff0c\u5247\u9577\u6548\u76ae\u8cea\u985e\u56fa\u9187\u7684\u55ae\u4e00\u808c\u8089\u6ce8\u5c04\uff0c\u53ef\u4f5c\u70ba\u53e3\u670d\u7d66\u4e88\u7684\u66ff\u4ee3\u65b9\u6cd5\u3002<\/p>\n

\u75db\u98a8\u9593\u671f\u53ca\u6162\u6027\u75db\u98a8\u77f3\u4e4b\u9810\u9632\u6027\u85e5\u7269\u6cbb\u7642<\/strong>
\n1. \u79cb\u6c34\u4ed9\u9e7c
\nColchicine \u5e38\u88ab\u7528\uf92d\u9810\u9632\u6025\u6027\u75db\u98a8\uf966\u767c\uff0c\u5728\u4f7f\u7528\ufa09\uf9bd\u9178\u85e5\u7269\u6cbb\uf9c1\u7684\u524d\u4e09\u5230\uf9d1\u500b\u6708\u53ef\u4ee5\u5408\u4f75\u4f7f\u7528\u4f4e\u5291\uf97e\u53e3\u670d\u79cb\u6c34\u4ed9\u7d20\uff0c\u4ee5\u6e1b\u5c11\u964d\u5c3f\u9178\u6cbb\u7642\u521d\u671f\u4e2d\u6025\u6027\u767c\u4f5c\u7684\u98a8\u96aa\u3002\u8d77\u59cb\u5291\u91cf\u70ba\u6bcf\u59290.5 mg\uff0c\u4e4b\u5f8c\u964d\u70ba\u6bcf\u5169\u59290.5 mg\uff0c\u6700\u5927\u5291\u91cf\u70ba1 mg\/ \u5929\u3002
\n2. \u5c3f\u9178\u5408\u6210\u6291\u5236\u5291
\n\u6025\u6027\u75db\u98a8\u95dc\u7bc0\u708e\u767c\u4f5c\u5f8c\u76841~2 \u5468( \u75bc\u75db\u5b8c\u5168\u7de9\u89e3) \u5f8c, \u624d\u53ef\u4f7f\u7528\u964d\u5c3f\u9178\u85e5\u7269\uff1aAllopurinol \u5c0d\u65bc\u518d\u767c\u6027\u75db\u98a8\u662f\u6709\u6548\u7684\uff0c\u7121\u8ad6\u662f\u5c3f\u9178\u6392\u6cc4\u904e\u5c11\u6216\u5408\u6210\u904e\u91cf\u6240\u5c0e\u81f4\u7684\u75db\u98a8\uff0c\u5b83\u5df2\u7d93\u6210\u70ba\u6700\u5ee3\u6cdb\u7528\u4f86\u9577\u671f\u8655\u7406\u75db\u98a8\u7684\u8655\u65b9\u85e5\uff0c\u4f46\u7528\u85e5\u5f8c\u82e5\u767c\u751f\u5589\u75db\u3001\u53e3\u8154\/ \u9ecf\u819c\u6f70\u721b\u3001\u76ae\u75b9\u7b49\u75c7\u72c0\uff0c\u61c9\u8003\u616e\u53ef\u80fd\u70ba\u56b4\u91cd\u85e5\u54c1\u4e0d\u826f\u53cd\u61c9\uff0c\u5b9c\u7acb\u5373\u5c31\u91ab\u4e26\u8003\u616e\u505c\u85e5\u3002\u5291\u91cf\u65b9\u9762\uff0c\u7121\u75db\u98a8\u77f3100-300 mg\/ \u5929\uff1b\u6162\u6027\u75db\u98a8\u77f3400-600 mg\/ \u5929\u3002
\n\u66fe\u4f7f\u7528\u904e\u964d\u5c3f\u9178\u85e5\u7269Benzbromarone \u6cbb\u7642\u53cd\u61c9\u4e0d\u4f73\uff0c\u5c3f\u9178\u503c\u4ecd\u9ad8\u65bc6.0 mg\/dL\u3001\u60a3\u6709\u6162\u6027\u814e\u81df\u75c5 (eGFR \uff1c 45 mL\/min\/1.73m2 \u6216serum creatinine \u2267 1.5mg\/dL) \u6216\u809d\u786c\u5316\u4e4b\u75db\u98a8\u75c5\u4eba\uff0c\u53ef\u9078\u7528Febuxostat\uff0c\u5efa\u8b70\u5291\u91cf40mg\/ \u5929\u3002
\n3. \u4fc3\u5c3f\u9178\u6392\u6cc4\u85e5
\n\u7d55\u5927\u591a\uf969( \u7d0490%) \u7684\u75c5\u60a3\uff0c\u5176\u9ad8\uf9bd\u9178\u8840\u75c7\u662f\uf9bd\u9178\u6392\u6cc4\u904e\u4f4e\u6240\u5f15\u8d77\uff0c\u800c\u4fc3\uf9bd\u9178\u6392\u6cc4\u85e5\u7269\u53ef\u4fc3\u4f7f\u814e\u81df\uf9bd\u9178\u6392\u6cc4\uff0c\u56e0\u6b64\u88ab\u8996\u70ba\u6b64\uf9d0\u75c5\u60a3\u4e4b\u9996\u9078\u85e5\u7269\u3002Benzbromarone(Nogout\u00ae) 100 mg\/ \u5929\u3002\u9032\u884c\u4fc3\u5c3f\u9178\u6392\u6cc4\u85e5\u7269\u7684\u6cbb\u7642\u6642\u61c9\u7531\u4f4e\u5291\u91cf\u958b\u59cb\uff0c\u4ee5\u907f\u514d\u986f\u8457\u7684\u5c3f\u9178\u5c3f\u548c\u7d50\u77f3\u5f62\u6210\u7684\u53ef\u80fd\u6027\u3002\u4e26\u4e14\u8981\u7d93\u5e38\u559d\u6c34\uff0c\u4f7f\u6bcf\u65e5\uf9bd\uf97e\u7dad\u63011,500-2,000\u897f\u897f\u4ee5\u4e0a\uff0c\u4ee5\u9810\u9632\uf9bd\uf937\uf9bd\u9178\u7d50\u77f3\u7684\u526f\u4f5c\u7528\u3002<\/p>\n

\u975e\u85e5\u7269\u6cbb\u7642<\/strong>
\n1. \u6e1b\u5c11\u5f9e\u98f2\u98df\u651d\u5165\u98fd\u548c\u8102\u80aa\u548c\u9ad8\u560c\u5464\u7684\u8089\u985e( \u4f8b\u5982\u52d5\u7269\u5167\u81df\u3001\u548c\u6d77\u9bae)\u3002
\n2. \u589e\u52a0\u6db2\u9ad4\u7684\u651d\u5165\u548c\u6e1b\u5c11\u9e7d\u985e\u8207\u9ad8\u679c\u7cd6\u7389\u7c73\u7cd6\u6f3f\uff08corn syrup\uff09\u98df\u54c1\u7684\u651d\u53d6\u3002
\n3. \u8b93\u95dc\u7bc0\u4f11\u606f1~2 \u5929\uff0c\u53ca\u5c40\u90e8\u51b0\u6577\u53ef\u80fd\u662f\u6709\u76ca\u7684\u3002\u61c9\u8a72\u907f\u514d\u95dc\u7bc0\u7684\u904b\u52d5\u53ca\u53d7\u5f71\u97ff\u5340\u57df\u7684\u71b1\u6577\uff0c\u56e0\u70ba\u5b83\u5011\u53ef\u80fd\u6703\u60e1\u5316\u75c5\u60c5\u3002
\n4. \u63d0\u5021\u4ee5\u9650\u5236\u71b1\u91cf\u651d\u53d6\u53ca\u904b\u52d5\u7684\u65b9\u5f0f\u4f86\u6e1b\u91cd\uff0c\u4e14\u53ef\u589e\u52a0\u814e\u81df\u7684\u5c3f\u9178\u6392\u6cc4\u91cf\u3002
\n5. \u9650\u5236\u9152\u7cbe\u7684\u651d\u53d6\uff0c\u6025\u6027\u7684\u9152\u7cbe\u651d\u53d6\u6703\u5f15\u8d77\u4e73\u9178\u8840\u75c7(lactic academia)\uff0c\u56e0\u800c\u6e1b\u5c11\u814e\u81df\u7684\u5c3f\u9178\u6392\u6cc4\uff0c\u800c\u9577\u671f\u98f2\u9152\u4fc3\u4f7f\u560c\u5464\u7684\u7522\u751f\uff0c\u560c\u5464\u70ba\u9152\u7cbe\u4ee3\u8b1d\u904e\u7a0b\u4e2d\uff0c\u918b\u9178\u8f49\u63db\u6210\u4e59\u91af\u8f14\u9176A(acetyl coenzyme A) \u7684\u526f\u7522\u7269\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

\u25a0 \u85e5\u5291\u79d1 \u5433\u5c1a\u502b \u85e5\u5e2b \u75db\u98a8\u53ef\u4ee5\u8aaa\u662f\u73fe\u4ee3\u4eba\u7684\u6587\u660e\u75c5\uff0c\u5b83\u662f\u56e0\u8840\u4e2d\uf9bd\u9178\u6fc3\ufa01\u904e\u9ad8\uff0c\u5f15 … \u95b1\u8b80\u5168\u6587 →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[97],"tags":[41],"class_list":["post-605","post","type-post","status-publish","format-standard","hentry","category-97","tag-health"],"_links":{"self":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/605","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=605"}],"version-history":[{"count":1,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/605\/revisions"}],"predecessor-version":[{"id":606,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/605\/revisions\/606"}],"wp:attachment":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=605"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}