降尿酸新方法治疗痛风性关节炎急性期临床观察

Clinical observation of the new method of reducing serum uric acid in acute phase of gout arthritis

目的观察比较非布司他与别嘌醇在痛风性关节炎急性期降尿酸治疗的效果。方法回顾性分析2013年6月至2016年10月在我院接受痛风性关节炎急性期治疗的73例患者的临床资料,根据患者接受降尿酸药物的不同,将服用非布司他的34例患者纳入观察组,而服用别嘌醇的39例患者纳入对照组。采用Likert量表法对患者治疗前后受累关节的疼痛、肿胀程度和皮肤颜色进行评估比较。比较两组患者治疗4d后的效果。结果两组患者治疗前关节疼痛、肿胀和皮肤发红程度,差异均无统计学意义(P>0.05)。经过4d治疗后,两组患者的3项评分均比治疗前有明显下降,差异均有统计学意义(P<0.05)。观察组患者治疗4d后关节疼痛和关节肿胀评分显著低于对照组(P<0.05),但两组治疗后的关节皮肤颜色差异无统计学意义(P>0.05)。两组患者接受治疗4d后,观察组总有效率为94.12%,而对照组总有效率为76.92%,两组差异有统计学意义(P<0.05)。结论非布司他作为降尿酸药物治疗痛风性关节炎急性期能够取得较好疗效,但对其使用剂量、联合药物方案等还需要进一步研究。

Objective To observe and compare the clinical effect of febuxostat and allopurinol on reducing serum uric acid in acute phase of gout arthritis.Methods A retrospective study of 73 patients in acute phase of gout arthritis treated in our hospital from June 2013 to October 2016 were performed.Based on different kinds of uric-acid-lowering drugs,patients taking febuxostat were involved into the observation group,while those taking allopurinol were included into the control group.Likert scales were employed to measure pain,swelling and rubefaction in involved joint before and after the treatment.The scores were compared between two groups.The clinical outcomes in two groups were also compared.Results The scores of pain,swelling and rubefaction in patients of two groups were not different before treatment(P>0.05).After four days' treatment,patients in both two groups had much lower scores than before(P<0.05).Patients in the observation group had significantly lower scores of joint pain and swelling than those in the control group(P<0.05).But there was no different score of rubefaction between two groups(P>0.05).The total effective rate in the observation group was 94.12%,while it in the control group was 76.92%(P<0.05).Conclusion Applying febuxostat as uric-acid drugs in the treatment of acute phase of gout arthritis has good clinical outcomes.But the dosage of it and combined drugs need to be further studied.