双氯芬酸不同剂型联合丁溴东莨菪碱治疗结石性肾绞痛临床疗效比较

Clinical Efficacy of Diclofenac Sodium with Different Dosage Forms Combined with Scopolamine N-Butyl Bromide in the Treatment of Calculus Renal Colic

目的:研究双氯芬酸钠栓剂直肠给药及双氯芬酸钠对乙酰氨基酚肌注联合丁溴东莨菪碱治疗结石性肾绞痛的有效性和安全性。方法:84例输尿管或肾盂结石需止痛治疗的肾绞痛患者给予足量抗菌药后随机分为直肠组和肌注组,直肠组42例患者给予丁溴东莨菪碱静滴联合双氯芬酸钠栓剂直肠给药,肌注组42例患者给予丁溴东莨菪碱静滴联合双氯芬酸钠对乙酰氨基酚肌注,观察并比较两组疗效及不良反应。结果:两组患者年龄、病程等差异无统计学意义(P>0.05)。首次用药0.5 h后,直肠组疼痛缓解总有效率69.05%,高于肌注组总有效率59.52%(P<0.05),1 h后两组患者疼痛缓解总有效率比较,差异无统计学意义(P>0.05),3 h后,直肠组疼痛复发率4.76%,低于肌注组19.04%(P<0.05),二次给药后两组患者疼痛缓解总有效率比较,差异无统计学意义(P>0.05),直肠组不良反应发生率显著低于肌注组(P<0.05)。结论:肌注双氯芬酸钠对乙酰氨基酚比双氯芬酸钠栓直肠给药镇痛更快,但镇痛效果维持较短,不良反应较多,而双氯芬酸钠栓直肠用药效果稳定持久,安全性高。

Objective： To research the efficacy and safety of diclofenac sodium rectal suppositories or intramuscular injection combined with scopolamine N-butyl bromide in the treatment of calculus renal colic. Methods： Totally 84 renal colic patients with gallstones in ureter or renal pelvis in need of sedative treatment after adequate antibiotics therapy were screened and randomly divided into the rectum group and the intramuscular injection group. The 42 patients in the rectum group were treated with scopolamine N-butyl bromide with intravenous drip and rectal suppositories of diclofenac sodium,and the 42 patients in the intramuscular injection group were given scopolamine N-butyl bromide with intravenous drip and diclofenac sodium intramuscular injection instead. The efficacy and adverse reactions were observed. Results： No statistically significant differences were found after the comparison of general information between the groups,such as age,duration of course of disease and so on（ P 〈0. 05）. In 0. 5 h after the first treatment,the total efficiency of pain relief in the rectum group was 69. 05%,which was higher than that（ 59. 52%） in the intramuscular injection group（ P 〈0. 05）,and that in the rectum group was similar to that in the intramuscular injection group in 1 hour after the first treatment（ P 〈0. 05）. The pain recurrence rate in the rectum group was 4. 76%,which was lower than that（ 19. 04%） in the intramuscular injection group in 3 hours after the first treatment（ P 〈0. 05）,while no statistically significant difference was obtained after the comparison of total efficiency between the groups（ P 〈0. 05）. The incidence of adverse reactions in the rectum group was significantly lower than that in the intramuscular injection group（ P 〈0. 05）. Conclusion： Although intramuscular injection of diclofenac sodium shows faster onset,it has shorter efficacy duration and more adverse reactions than rectal suppositories of diclofenac sodium.