目的:比较非布索坦联合低嘌呤饮食与别嘌呤醇联合低嘌呤饮食治疗痛风的临床疗效。
方法:在这项前瞻性对照试验中,从2021年2月至2022年12月我院收治的98例痛风患者作为研究对象。患者被随机分为研究组(非布索坦联合低嘌呤饮食)和对照组(别嘌呤醇联合低嘌呤饮食),每组49例。根据治疗后的关节功能和血清尿酸水平评估治疗效果。分为三个级别:显着有效,有效,和无效。炎症因子的水平,包括肿瘤坏死因子-a(TNF-a),细胞因子白细胞介素-1β(IL-1β),和白细胞介素(IL)-18(IL-18),被收集。使用数字评定量表(NRS)评估患者的疼痛程度。比较两组患者治疗前及治疗后6个月的临床指标。
结果:两组之间的年龄和性别无统计学意义。经过6个月的治疗,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,研究组血清尿酸水平明显降低(162.39μmol/L±17.23μmol/Lvs.S198.32μmol/L±18.34μmol/L,p<.001),肌酐(87.39mmol/L±9.76mmol/Lvs.92.18mmol/L±9.27mmol/L,p=.014),总胆固醇(3.65mmol/L±0.65mmol/Lvs.4.76mmol/L±0.73mmol/L,p<.001),和甘油三酯(1.76mmol/L±0.32mmol/Lvs.2.28mmol/L±0.41mmol/L,p<.001)与对照组相比,差异有统计学意义(p<0.05)。治疗后,研究组患者的炎症因子水平和疼痛程度均显著低于对照组(均p<0.05)。在治疗过程中,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)。
结论:非布索坦联合低嘌呤饮食可降低痛风患者的炎症因子,减轻疼痛程度。显著改善其临床症状。
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).
CONCLUSIONS: 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.