药物排石疗法在治疗5～10mm输尿管结石的疗效观察

Medical expulsive therapy for patients with 5-10 mm ureteral stones

目的评价阿夫唑嗪、尿石通和双氯芬酸三联用药治疗输尿管结石的疗效。方法把人选的81例患者随机分为实验组和对照组，实验组用药方案：阿夫唑嗪（2．5mg/片），2次／d，1片／次；尿石通（4∥包），2次／d，1包／次；双氯芬酸钠缓释片（75mg／片），2次／d，每次1片，连服用3d后改按需服用，疼痛时服用1片，用药时间为4周。对照组单服双氯芬酸钠缓释片，服用方案和实验组一样，有结石排出即终止服药，观察时间为4周。结果81例患者中结石排出率为60．5％（49／81）；实验组总结石排出率比对照组高出36．0％（P〈O．05）；实验组上段结石和下段结石排除率分别比对照组高出41．5％（P〈0．01）和27．5％（P〉0．05）。两组疼痛缓解方面差异无统计学意义（P〉0．05）。两组疼痛控制效果均比较理想，平均缓解天数3d左右。结论阿夫唑嗪、尿石通和双氯芬酸三联用药治疗输尿管结石可提高结石排出率，使更多患者避免体外碎石和输尿管镜碎石。

Objectives To evaluate the effect of the combination of aofuzosin, Niaoshitong, and diclofenac for patients with ureteral stone. Methods 81 patients were randomized into an experimental group and a control group. The experimental group took alfuzosin （2.5 mg/tablet） twice a day and 1 tablet per time, Niaoshitong （4 g/bag） twice a day and 1 bag per time, and diclofenac （75 mg/tablet） twice a day and 1 tablet per time for 4 week. The control group took diclofenac （75 rag/tablet） twice a day and 1 tablet per time for 4 weeks. When the stone was expulsed, the medication was stopped. Both groups were observed 4 weeks. Results Among the 81 patients, the stone-expulsed rate was 60.5% （ 49/81 ） . The stone-expulsed rate was 77.5% in the experimental group and was 41.5% in the control group （ P 〈 0.05 ） . The expulsed rates of upper and lower ureteral stones were 7.0.1% and 87.5% in the experimental group and were 28.6% and 60.0% in the control group （P 〈 0.05）. There was no statistical difference in pain-relieving between these two groups. Both groups had good pain control effect. The pain-relieving time was about 3 days in both groups, for the lower ureteral stone,the rate was increased by 27.5% （P 〉 0.05）. Conclusions The combination of aofuzosin, Niaoshitong, and diclofenac for patients with ureteral stone can increase the stone-expulsed rate and avoid URSL and ESWL.