摘要
目的观察枸橼酸氢钾钠颗粒联合非布司他片治疗痛风伴有痛风石患者的临床效果。方法选取2022年1月—2023年1月广州中医药大学顺德医院住院及门诊收治的痛风伴有痛风石患者60例,1例患者被剔除。根据随机数字表法分为联合用药组29例和单一用药组30例。单一用药组给予非布司他片治疗,联合用药组在单一用药组基础上予以枸橼酸氢钾钠颗粒治疗,2组疗程均为12个月。比较2组临床疗效,治疗前后尿酸盐结晶体积,治疗前与治疗第1、6、12个月后尿液pH和血尿酸、C反应蛋白(CRP)水平,记录治疗过程中出现的不良反应。结果联合用药组治疗总有效率为96.55%,高于单一用药组的73.34%(χ^(2)=4.484,P=0.034)。治疗12个月后,2组双能CT检测结果显示尿酸盐结晶体积缩小(P<0.01)。联合用药组治疗第1、6、12个月后24 h尿液pH较治疗前增高,且各时间点均高于单一用药组(P<0.05或P<0.01);单一用药组治疗第1、6、12个月后24 h尿液pH无明显变化(P>0.05)。2组治疗第1、6、12个月后血尿酸、血清CRP水平较治疗前呈下降趋势,且联合用药组治疗后第12个月后血尿酸水平低于单一用药组(P<0.05),其他时点2组血尿酸、血清CRP水平比较差异无统计学意义(P>0.05)。联合用药组和单一用药组的不良反应总发生率分别为24.14%、13.33%,差异无统计学意义(χ^(2)=1.135,P=0.287)。结论枸橼酸氢钾钠颗粒联合非布司他片治疗痛风伴有痛风石的临床疗效显著,可通过碱化尿液,促进尿酸排泄,抑制尿酸盐结晶形成,起到溶石和抑制新生尿酸盐结晶形成的作用,且用药安全性较高。
Objective To observe the clinical effect of potassium sodium hydrogen citrate granules combined with febuxostat tablets in the treatment of patients with gout and tophi.Methods A total of 60 patients with gout and tophi were admitted to Shunde Hospital Guangzhou University of Chinese Medicine from January 2022 to January 2023 were enrolled,and 1 patient was excluded.According to the random number table method,the patients were divided into the combination drug group(29 cases)and in the single drug group(30 cases).The single drug group was treated with febuxostat tablets,and the combination group was treated with potassium sodium hydrogen citrate granules on the basis of the single drug group,and the course of treatment in both groups was 12 months.The clinical efficacy,the volume of urate crystals before and after treatment,urine pH and serum uric acid and CRP levels before and after the 1st,6th and 12th months of treatment between the two groups were compared,and the adverse reactions during treatment were recorded.Results The total effective rate of the combination drug group was 96.55%,which was higher than that of the single drug group(73.34%)(χ^(2)=4.484,P=0.034).After 12 months of treatment,the results of dual-energy CT in the two groups showed that the crystal volume of urate decreased(P<0.01).The urine pH value of the combination drug group increased at 24 h after the 1st,6th and 12th months of treatment compared with that before treatment,and were higher than those of the single drug group at each time point(P<0.05 or P<0.01),while the urine pH value of the single drug group did not change significantly at 24 h after the 1st,6th and 12th months of treatment(P>0.05).The serum uric acid and serum CRP levels in the two groups decreased after the 1st,6th and 12th months of treatment compared with those before treatment,and the serum uric acid levels in the combination drug group were lower than those in the single drug group after the 12th month after treatment(P<0.05),and there was no significant difference in the serum uric acid and serum CRP levels between the two groups at other time points(P>0.05).The total incidence of adverse reactions in the combination drug group and the single drug group were 24.14%and 13.33%,respectively,and the difference was not statistically significant(χ^(2)=1.135,P=0.287).Conclusion The clinical efficacy of potassium sodium hydrogen citrate granules combined with febuxostat tablets in the treatment of gout accompanied by tophi is significant,which can promote uric acid excretion,inhibit the formation of urate crystals,and play a role in dissolving stones and inhibiting the formation of new urate crystals by alkalizing urine,and the drug safety is high.
作者
王实
何志琴
黄荣姬
WANG Shi;HE Zhiqin;HUANG Rongji(Shunde Hospital Guangzhou University of Chinese Medicine,Guangdong Province,Foshan 528300,China)
出处
《临床合理用药》
2025年第15期14-17,共4页
Chinese Journal of Clinical Rational Drug Use
基金
2022年度佛山市卫生健康局医学科研项目(20220303)。
关键词
痛风
痛风石
枸橼酸氢钾钠颗粒
非布司他片
双能CT
血尿酸
C反应蛋白
Gout
Chalkstone
Potassium sodium hydrogen citrate granules
Febuxostat tablets
Dual-energy CT
Serum uric acid
C-reactive protein
