呋塞米联合坦索罗辛治疗输尿管下段结石的临床研究

Clinical Study of Furosemide and Tamsulosin Therapy with Lower Nreteral Calculus

目的：评价呋塞米联合坦索罗辛治疗输尿管下段结石的临床效果。方法：90例确诊单纯榆尿管下段结石的患者，年龄15—71岁，结石4．0—10．0mm，随机分为3组：空白对照组、坦索罗辛（0．2mg，1次／d）对照组、联合治疗组（服用坦索罗辛和呋塞米）。3组间患者的年龄、性别、结石直径等差异均无统计学意义。随访2周，观察结石排出率、结石排出时间、肾绞痛发生、镇痛荆使用情况和药物不良反应。结果：联合治疗组、坦索罗辛组的结石完全排出率分别为93．0％、72．0％，均显著高于对照组的38．0％（P均〈0．05）；结石排出时间、肾绞痛发生率和镇痛剂的使用率分别为（8．10±1．57）d、20．0％、6．7％和（9．31±1．60）d、48．0％、24．0％，也均显著低于对照组的（12．10±1．72）d、63．0％和54．0％（P均〈0．05）。且联合治疗组的结石排出率明显高于坦索罗辛组，结石排出时间、肾绞痛发生率和镇痛药使用率也均低于后者。3组患者均未观察到明显的药物不良反应。结论：呋塞米联合坦索罗辛明显促进输尿管下段结石排出，缓解肾绞痛发生，可作为一种有效的输尿管下段结石药物疗法。

Objective：To evaluate the efficacy of tamsulosin association with Furosemide in treatment of lower ureteral. Methods：A total of 90 consecutive patients with single radiopaque lower ureteral calculi were enrolled in the study. The stone diameter was 4 - 10mm and patient age was 15 - 71 years. All patients were randomized in three groups. Group 1 did not receive any medical treatment as blank control group. Group 2 received tamsulosin 0. 2mg/day and group 3 received tamsulosin plus Furosemide 40mg/day for two weeks. No significant differences were found among the three groups concerning age, gender distribution and maximum stone diameter. Efficacy was evaluated in term of stone expulsion rate, expulsion time, pain episodes, analgesic use and adverse drug reaction during a week of follow up. Results： The successful stone expulsion rate was 93.0% and 72.0% in the combination treatment group and tamsulosin group, which was significantly higher than 38.0% in the control group （P 〈0. 05）. The stone expulsion time, pain episodes rate and analgesic use rate were （8. 10 ± 1.57） days, 20. 0%, 6. 7% and （9. 31 ± 1.60） days, 48. 0%, 24. 0%, which were also significantly lower than those in the control group, which were （ 12. 10 ± 1.72） days, 63. 0% and 54.0%, respectively. Moreover, the stone expulsion rate and expulsion time of the combination group were significantly higher than those of the tamsulosin group, while pain episodes＇ rate, analgesic use rate were significantly lower. No serious adverse drug reaction was found in the three groups. Conclusions：The combined use of tamsulosin and Furosemide increases stone expulsion and relieves renal colic episode, which should be recommended in the treatment for lower ureterm calculi.