比较非布司他联合低嘌呤饮食与别嘌醇联合低嘌呤饮食对改善痛风患者的疗效。

Comparison of the therapeutic effects of febuxostat combined with a low-purine diet and allopurinol combined with a low-purine diet on the improvement of gout patients.

机构信息

Department of Medical Affairs, Affiliated Hospital of Hebei Engineering University, Handan, China.

Department of Rheumatology, Affiliated Hospital of Hebei Engineering University, Handan, China.

出版信息

Int J Rheum Dis. 2024 May;27(5):e15165. doi: 10.1111/1756-185X.15165.

DOI:10.1111/1756-185X.15165

PMID:38769820

Abstract

OBJECTIVE

To compare the clinical efficacy of febuxostat combined with a low-purine diet versus allopurinol combined with a low-purine diet in the treatment of gout.

METHODS

In this prospective controlled trial, 98 gout patients admitted to our hospital from February 2021 to December 2022 were enrolled as study subjects. Patients were randomly assigned to the study group (febuxostat combined with a low-purine diet) and the control group (allopurinol combined with a low-purine diet), with 49 patients in each group. The therapeutic effect was evaluated based on joint function and serum uric acid levels after treatment, and classified into three levels: markedly effective, effective, and ineffective. The levels of inflammatory factors, including tumor necrosis factor-a (TNF-a), cytokine interleukin-1beta (IL-1β), and interleukin (IL)-18 (IL-18), were collected. The Numeric Rating Scale (NRS) was used to assess the degree of pain in patients. Clinical indicators before and 6 months after treatment were compared between the two groups.

RESULTS

There was no statistically significant difference in age and gender between the two groups. After 6 months of treatment, the effective rate in the study group (48 cases, 97.96%) was higher than that in the control group (42 cases, 85.71%), with a statistically significant difference (p = .027). At the same time, the study group had significantly lower levels of serum uric acid (162.39 μmol/L ± 17.23 μmol/L vs. S198.32 μmol/L ± 18.34 μmol/L, p < .001), creatinine (87.39 mmol/L ± 9.76 mmol/L vs. 92.18 mmol/L ± 9.27 mmol/L, p = .014), total cholesterol (3.65 mmol/L ± 0.65 mmol/L vs. 4.76 mmol/L ± 0.73 mmol/L, p < .001), and triglycerides (1.76 mmol/L ± 0.32 mmol/L vs. 2.28 mmol/L ± 0.41 mmol/L, p < .001) compared to the control group, with statistically significant differences (p < .05). After treatment, the levels of inflammatory factors and degree of pain in the study group were significantly lower than those in the control group (all p < .05). During the treatment process, the incidence of adverse reactions in the study group (2 cases, 4.08%) was lower than that in the control group (9 cases, 18.37%), with a statistically significant difference (p = .025).

CONCLUSION

Febuxostat combined with a low-purine diet can reduce inflammatory factors and alleviate the degree of pain in gout patients, significantly improving their clinical symptoms.

摘要

目的

比较别嘌醇与非布司他联合低嘌呤饮食治疗痛风的临床疗效。

方法

前瞻性对照试验，纳入 2021 年 2 月至 2022 年 12 月我院收治的 98 例痛风患者，采用随机数字表法分为研究组（别嘌醇联合低嘌呤饮食）和对照组（非布司他联合低嘌呤饮食），每组 49 例。根据治疗后关节功能和血尿酸水平评价疗效，分为显效、有效和无效。采集两组患者炎性因子肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-18（IL-18）水平，采用数字评分法（NRS）评估患者疼痛程度，比较两组患者治疗前后临床指标。

结果

两组患者年龄、性别比较差异无统计学意义。治疗 6 个月后，研究组有效率（48 例，97.96%）高于对照组（42 例，85.71%），差异有统计学意义（P=0.027）。同时，研究组患者血尿酸（162.39 μmol/L±17.23 μmol/L 比 198.32 μmol/L±18.34 μmol/L，P<0.001）、肌酐（87.39 mmol/L±9.76 mmol/L 比 92.18 mmol/L±9.27 mmol/L，P=0.014）、总胆固醇（3.65 mmol/L±0.65 mmol/L 比 4.76 mmol/L±0.73 mmol/L，P<0.001）、三酰甘油（1.76 mmol/L±0.32 mmol/L 比 2.28 mmol/L±0.41 mmol/L，P<0.001）水平均低于对照组，差异有统计学意义（P<0.05）。治疗后，研究组炎性因子及疼痛程度均低于对照组，差异均有统计学意义（均 P<0.05）。治疗过程中，研究组不良反应发生率（2 例，4.08%）低于对照组（9 例，18.37%），差异有统计学意义（P=0.025）。