坦索罗辛对于远端输尿管结石治疗作用的临床随机对照研究

The Clinic Randomized Research of the Medical-expulsive Therapy for Distal Ureterolithiasis Used with Tamsulosin

目的评估а1受体阻滞剂类药物——坦索罗辛作为远端输尿管结石的排石药物的临床疗效。方法 203例远端输尿管结石患者随机分为2个治疗组。组1(对照组,100例)接受目前临床常用排石中药—净石灵治疗(1.5mgTid/d);组2(药物组,103例)接受坦索罗辛治疗(0.4mg/d)。研究持续时间至结石排出或28d内。统计分析方法采用independent-SamplesTTest、四格表资料的χ2检验、Cox回归分析及非条件logistic回归分析。结果 2组排石率、排石时间及需要使用止痛药的例数具有显著性差异;需进入急诊室或者入院治疗、误工时间、发生严重药物副反应等情况无统计学差异。生活质量评分(QOL)2组间无显著性差异,但坦索罗辛治疗组的平均评分低于净石灵治疗组。结论使用坦索罗辛可提高输尿管远端结石排石率,减少排石时间,且副反应的发生率低。临床使用坦索罗辛进行输尿管远端结石治疗具有良好的疗效。

Objective To assess the clinical efficacy of the α1 blocker—tamsulosin in the medical-expulsive therepy of distal ureterolithiasis.Methods A total of 203 patients with stones located in the lower ureter（juxtavesical or intramural tract） were enrolled in the study and were randowly divided into 2 groups.Group-1（100）patients received daily oral treatment of Jingshiling Jiaonang（1.5Tid/day）,Group-2 received daily oral treatment of tamsulosin（0.4mg/day）.The treatment period was 28 days for both groups.Statistical analyses were performed using independent-Samples T Test、chi-square Test、Cox Regression model and independent Logistic Regression.Results Expulsion was observed in 62 of 100 patients in group-1（62%）,82 of 103 in group-2（79.6%）.The difference in group-1 with respect to group-2 was significant.Average expulsion time for group-1 and group-2was 10.8 days and 8.51 days.A statistical significant difference was noted in the two grouops.In the treatment time,there was not significant difference in the two groups with ER visits and Urgent hospitalization、workdays lost and durg side effects.The QOL of two groups have not significant difference,but the average value of group-2 was lower than group-1.Conclusion The results of this study indicate that lower tract ureteral stones can be treated with an expulsive medical therapy in patients when a watchful waiting approach is possible.In our study medical treatments with tamsulosin proved to be safe and effective as demonstrated by the low incidence of side effects and the increased stone expulsion rate and reduce expulsion times.