非布司他联合苯溴马隆治疗痛风性关节炎伴多发痛风石形成

Curative effect of febuxostat combined with benzbromarone on gouty arthritis with multiple tophus

目的探讨非布司他联合苯溴马隆治疗痛风性关节炎伴多发痛风石形成的疗效及安全性。方法选取2016年1月~2019年1月成都医学院第一附属医院就诊的痛风性关节炎且伴多发痛风石患者90例,采用随机数字表法分为联合组和单药组,每组各45例,单药组给予苯溴马隆片治疗,联合组在单药组的基础上加服非布司他片治疗,治疗两个月后评价两组患者疗效,并比较两组患者治疗前后痛风症状改善状况、痛风石大小及数目、肝功能指标及血清炎症因子变化情况。结果治疗两个月后,联合组总有效率显著大于单药组(P<0.05)。治疗后两组关节疼痛评分、关节畸形评分、受累关节数较治疗前明显下降(P<0.05),而联合组下降幅度显著大于单药组,差异有统计学意义(P<0.05)。两组治疗前后肝功能指标差异均无统计学意义(P>0.05),而联合组尿酸下降幅度显著大于单药组,差异有统计学意义(P<0.05)。治疗后两组C反应蛋白(CRP)、血沉(ESR)水平均显著下降(P<0.05),而联合组下降幅度显著大于单药组,差异有统计学意义(P<0.05)。结论非布司他联合苯溴马隆治疗痛风性关节炎伴多发痛风石形成的疗效显著,可显著改善患者临床症状,降低机体炎症水平,且对肝功能影响较小,可在临床推广应用。

Objective To explore curative effect and safety of febuxostat combined with benzbromarone on gouty arthritis(GA)and multiple tophus.Methods Ninety patients with GA and multiple tophus treated in the hospital from January 2016 to January 2019 were enrolled.They were divided into Combined group and Single drug group by random number table,45 cases in each group.The Single drug group was treated with benzbromarone,while Combined group was treated with febuxostat on basis of Single drug group.After 2 months of treatment,curative effect of both groups was evaluated.The improvement of gout symptoms,size and number of tophus,changes in liver function indexes and serum inflammatory factors before and after treatment were compared between the two groups.Results After 2 months of treatment,total response rate of Combined group was significantly higher than that of Single drug group(93.33%vs 73.56%)(P<0.05).After treatment,scores of joint pain and joint deformity,and number of involved joints in both groups were significantly decreased(P<0.05).The decline amplitude of Combined group was significantly greater than that of Single drug group(P<0.05).Before and after treatment,there were no differences in liver function indexes between the two groups(P>0.05).The decline amplitude of uric acid(UA)in Combined group was significantly greater than that in Single drug group(P<0.05).After treatment,levels of C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in both groups were significantly decreased(P<0.05).The decline amplitude of Combined group was significantly greater than that of Single drug group(P<0.05).Conclusion Febuxostat combined with benzbromarone is markedly effective in the treatment of GA with multiple tophus.It can significantly improve clinical symptoms of patients,reduce the level of inflammation,withut little influence on liver function.