苯溴马隆与别嘌呤醇治疗原发性痛风高尿酸血症疗效与安全性比较的Meta分析

Efficacy and Safety of Benbromarne and Allopurinol for Primary Gout ULT:A Meta-Analysis

目的系统评价苯溴马隆与别嘌呤醇比较治疗原发性痛风高尿酸血症的疗效和安全性。方法计算机检索PubMed、EMbase、Cochrane图书馆、CNKI、VIP和CBM等电子数据库,查找苯溴马隆与别嘌呤醇比较治疗原发性痛风高尿酸血症的随机对照试验(RCT),检索时限均从建库至2011年7月。对符合纳入标准的RCT,由两位评价员按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用RevMan 5.1软件进行Meta分析。结果共纳入6个RCT,350例原发性痛风患者。Meta分析结果显示,苯溴马隆与别嘌呤醇在治疗原发性痛风高尿酸血症的总有效率方面,两组差异无统计学意义[RR=1.21,95%CI(0.98,1.50),P=0.07];在不良反应方面,两组差异有统计学意义[RR=0.44,95%CI(0.23,0.84),P=0.01],苯溴马隆的安全性更好。结论现有研究证据显示,苯溴马隆在治疗原发性痛风高尿酸血症的疗效方面与别嘌呤醇相当,但不良反应少于别嘌呤醇,主要为食欲不振等胃肠道症状。由于纳入研究的方法学质量存在中度选择性偏倚的可能性,可能影响结果真实性,因此上述结论还有待开展更多高质量、大样本、随机双盲临床对照试验来验证。

Objective To compare the efficacy and safety of benzbromarone vs. allopurinol for primary gout. Meth- ods Searching PubMed, Cochrane Library, EMbase, CNKI, VIP and CBM, randomized controlled trials were collected and the quality of RCTs was evaluated using Cochrane systematic review. Meta-analysis was performed. Results 6 RCTs were included in this study,with a total of 350 patients. Meta-analysis showed that there was no statistical significance in total effective rate between two groups （P〉0.05）. 4 RCTs were enrolled in comparison of ADR. There was statistical sig- nificance between two groups （P〈0.05）. Conclusion There is no significant difference in the efficacy between benzbro- marone and allopurinol for the primary gout.But benzbromarone is safe than allopurinol for primary gout.