萘哌地尔治疗输尿管下段结石的疗效观察

Curative Effects Observation of Naftopidil on the Number and Intensity of Ureteral Colic in Patients with Lower Ureteral Calculus

目的:探讨萘哌地尔α1受体阻滞剂对输尿管下段结石患者的临床效果。方法:选择250例输尿管下段包括近膀胱段或膀胱壁段结石患者,随机分为两组,治疗组120例给予非甾体抗炎药物双氯芬酸钠缓释片75mg/d,保守治疗。实验组130例使用萘哌地尔25mg/d,加保守治疗。所有患者随访4周,观察患者排石过程中输尿管绞痛的发生次数,疼痛严重程度的VAS得分以及结石的排出率进行评价。结果:实验组与治疗组结石的排出率分别为84.6%(110/130)和62.5%(75/120)有显著性差异(P<0.05)。结石直径6mm(P=0.634)和>6mm(P=0.408)两组比较无显著差异。治疗组输尿管绞痛的发生次数明显高于实验组,VAS得分治疗组明显高于实验组,差异有显著性意义(P<0.05)。结论:萘哌地尔α-受体阻滞剂对输尿管下段结石排出过程中减少绞痛的发生次数或程度,对提高患者的排石率和生活质量有较好效果。

Objective We aimed to objectively determine whether naftopidil as an a-blocker was effective in patients who had ureterolithiasis located in the lower part of the ureteral. Methods 250 patients with lower ureteral calculi （juxtavesical or intramural portion） were randomly divided into two groups in the present study, conservative treatment, Diclofanac sodium sustained tablets （75 mg daily）, as a nonsteroidal anti-inflammatory drug, was given to the control group （120 patients）, the trial group （130 patients） was given Naftopidil （25 mg daily） in addition to the conservative treatment. All patients were followed up for 4 weeks and questioned about the numbers and intensity of ureteral colic, and the rate of spontaneous passage after the procedure. Results Spontaneous passage was observed in 75 patients of the control group （62.5%） and in 110 patients of the trial group （84.6%）, the difference between both groups was significant （P 〈 0.05）. The stone diameter was 6 mm （P = 0.635） or 〉 6 mm （P = 0.407）, the difference between both groups was not statistically significant. The control group patients were passing their stones, they had more ureteral colic episodes than the trial group patients, this difference was statistically significant. The control group patients reported higher scores according to a visual analog scale than the trial group patients. Also, this difference was statistically significant （P 〈 0.05）. Conclusion We think that the treatment of α- receptor blockers decreased the number of ureteral colic episodes and the intensity of pain during spontaneous passage at the lower ureteral calculi, and it will be beneficial to patients＇ quality of life.