双氯芬酸钠利多卡因联合丁溴东莨菪碱治疗急性肾绞痛的临床疗效观察

Clinical Curative Effect of Diclofenac Sodium Lidocaine Combined with Scopolamine Butylbromide in the Treatment of Acute Renal Colic

目的探讨双氯芬酸钠利多卡因联合丁溴东莨菪碱治疗急性肾绞痛的临床疗效。方法选择2010年8月—2012年2月我院收治的1 350例急性肾绞痛患者,随机分为A、B、C 3组,每组各450例。A组采用黄体酮+阿托品治疗,B组采用哌替啶+阿托品治疗,C组采用双氯芬酸钠利多卡因+丁溴东莨菪碱治疗。采用疼痛标尺或示意图的口诉评分法(VRS评分)评价治疗前后疼痛程度,并观察3组的临床疗效、急性肾绞痛复发情况及不良反应发生情况。结果 3组治疗前VRS评分比较,差异无统计学意义(F=4.809,P=0.184);治疗后VRS评分比较差异有统计学意义(F=12.461,P=0.025),其中C组VRS评分低于A组和B组(P<0.05),A、B两组间差异无统计学意义(P>0.05)。3组有效率、复发率及不良反应发生率比较,差异均有统计学意义(χ2=71.549,13.893,16.961;P均<0.05),其中C组均低于A组和B组(P<0.05),而A、B两组间差异均无统计学意义(P>0.05)。结论双氯芬酸钠利多卡因联合丁溴东莨菪碱治疗急性肾绞痛的疗效显著,不良反应少,值得临床推广应用。

Objective To investigate the clinical effect of diclofenac sodium lidocaine combined with scopolamine bu- tylbromide in the treatment of acute renal colic. Methods 1 350 patients with acute renal colic admitted to our hospital from Au- gust 2010 to February 2012 were randomly divided into group A, group B and group C, with each group 450 cases. Group A wasgiven progesterone ＋ atropine, group B was given pethidine ＋ atropine and group C was given scopolamine butylbromide ＋ diclofe- nac sodium lidocaine. The pain degree of before and after treatment were evaluated by pain scale or schematic diagram mouth sco- ring method （VRS）, and the clinical effect, acute renal colic recurrence and adverse reactions were observed in the three groups. Results The VRS between the three groups showed no statistically significant difference before treatment （ F = 4. 809, P =0. 184）, but showed statistically significant difference after treatment （F = 12. 461, P =0. 025） . The VRS of group C was significantly lower than group A and group B （P 〈 0. 05 ）, but VRS between group A and group B showed no statistically signifi- cant difference （P 〉 0. 05） . Clinical effect, acute renal colic recurrence and adverse reactions between the three groups showed statistically significant differences （χ2 = 71. 549, 13. 893, 16. 961 ; P all 〈 0. 05 ） . The above indexes in group C were all sig- nificantly lower than group A and group B, but no statistically significant difference was found between group A and group B （P 〉 0. 05） . Conclusion Diclofenac sodium lidocaine combined with scopolamine butylbromide should be recommended in clinic because it is significant effective with fewer adverse events.