CAJ | 학술논문

目的：评价非布司他与别嘌醇治疗痛风的有效性和安全性。方法在PubMed、EmBase、Cochrane图书馆、CNKI和CBM数据库中检索非布司他的随机对照试验（ RCTs ）。2名作者分别独立进行文献筛选、质量评价和数据提取，根据Cochrane系统评价的原理和方法，使用Cochrane协作网提供的RevMan 5.2.7软件进行Meta分析。结果 Meta分析最终纳入5个RCTs。与别嘌醇相比，接受非布司他治疗的患者血清尿酸（sUA）水平更易于降低至6 mg· dL－1以下，且降幅明显高于对照组（P＜0.05），但是，非布司他并未降低痛风的发作率。非布司他组的不良反应发生率低于别嘌醇组。结论虽然非布司他更容易将 sUA 降至6 mg· dL－1以下，但没有证据表明非布司他预防痛风发作的效果优于别嘌醇，且非布司他价格昂贵，不应作为治疗慢性痛风的常规选择，除非患者合并肾功能不全。
목적：평개비포사타여별표순치료통풍적유효성화안전성。방법재PubMed、EmBase、Cochrane도서관、CNKI화CBM수거고중검색비포사타적수궤대조시험（ RCTs ）。2명작자분별독립진행문헌사선、질량평개화수거제취，근거Cochrane계통평개적원리화방법，사용Cochrane협작망제공적RevMan 5.2.7연건진행Meta분석。결과 Meta분석최종납입5개RCTs。여별표순상비，접수비포사타치료적환자혈청뇨산（sUA）수평경역우강저지6 mg· dL－1이하，차강폭명현고우대조조（P＜0.05），단시，비포사타병미강저통풍적발작솔。비포사타조적불량반응발생솔저우별표순조。결론수연비포사타경용역장 sUA 강지6 mg· dL－1이하，단몰유증거표명비포사타예방통풍발작적효과우우별표순，차비포사타개격앙귀，불응작위치료만성통풍적상규선택，제비환자합병신공능불전。
Objective To evaluate the efficacy and safety of febuxostat compared to allopurinol for the treatment of gout.Methods Randomized controlled trials ( RCTs ) of febuxostat were retrieved from PubMed , EmBase , the Cochrane Library , CNKI and CBM databases.Two revie-wers independently selected studies , assessed study quality , and extrac-ted data.According to the principles and methods of Cochrane systematic reviews , the included RCTs were analyzed by the software RevMan 5.2.7 provided by the Cochrane collaboration .Results Five studies were ulti-mately included in the analysis.Patients receiving febuxostat were more likely to achieve a serum uric acid ( sUA) of 6 mg· dL-1 than allopurinol recipients .The decline from baseline in sUA levels was more obvious in febuxostat group than allopurinol (P<0.05).However, febuxostat did not reduce the risk of gout flares compared with allopurinol .Overall , the risk of adverse drugs reaction was lower in febuxostat recipients than allopuri -nol.Conclusions Although febuxostat demonstrated a higher likelihood of achieving a target sUA level of <6 mg· dL-1 , however , there was no evidence that febuxostat is better than allopurinol for preventing gout flare .Taken its higher cost into consideration , febuxostat should not be the rou-tine option for chronic gout , except for those patients with renal dysfunction.