不同剂量山莨菪碱注射液对输尿管结石绞痛发作的临床效果评价

Evaluation of Clinical Effect of Different Doses of Anisodamine Injection on Ureteral Calculus Colic Attack

目的探讨输尿管结石绞痛发作患者给予不同剂量山莨菪碱注射液的临床效果。方法选取2021年4月至2022年3月我院收治的共计86例输尿管结石绞痛发作患者,按照随机数字表法分成研究组(43例)与对照组(43例),对照组男性22例,女性21例,年龄(53.39±5.23)岁,研究组男性23例,女性20例,年龄(53.29±5.15)岁,对照组给予山莨菪碱注射液10mg/次,研究组给予山莨菪碱注射液20mg/次,比较两组镇痛效果、疼痛介质、应激指标、尿生化指标及不良反应发生率,计数资料采用χ^(2)检验,计量资料采用独立样本t检验或配对资料t检验。结果研究组(93.02%)与对照组(74.42%)相比镇痛总有效率更高(P<0.05);两组治疗后β-内啡肽(β-EP)水平提高(P<0.05),P物质(SP)、前列腺素E2(PGE2)水平降低(均P<0.05),研究组与对照组相比β-EP[(20.18±2.75)ng/mL比(16.33±2.82)ng/mL]水平更高(P<0.05),SP[(0.36±0.08)μg/mL比(0.57±0.10)μg/mL]、PGE2[(42.29±5.03)pg/mL比(57.18±5.53)pg/mL]水平更低(均P<0.05);两组治疗后去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、皮质醇(Cor)水平降低(均P<0.05),研究组与对照组相比NE[(35.81±2.76)μg/L比(46.13±2.92)μg/L]、AngⅡ[(56.78±3.22)pg/mL比(85.36±5.04)pg/mL]、Cor[(153.24±21.19)μg/L比(187.01±20.43)μg/L]更低(均P<0.05);两组治疗后尿酸(UA)、尿钙(UC)、尿草酸(Ox)水平降低(均P<0.05),研究组与对照组相比UA[(0.39±0.11)mmol/d比(0.52±0.16)mmol/d]、UC[(3.79±1.03)mmol/d比(5.44±1.29)mmol/d]、Ox[(2.49±0.73)mmol/d比(3.85±1.06)mmol/d]更低(均P<0.05);研究组与对照组不良反应发生率(9.30%比6.98%)比较差异无统计学意义(P>0.05)。结论输尿管结石绞痛发作患者给予山莨菪碱注射液20mg/次,可提高镇痛效果,调节疼痛介质、应激指标及尿生化指标水平,且用药安全性较高。

Objective To explore the clinical effect of different doses of anisodamine injection in patients with colic attack of ureteral calculi.Methods A total of 86 patients with ureteral calculi colic attack who were treated in our hospital from April 2021 to March 2022 were selected,and they were divided into the research group(43 cases)and the control group(43 cases)by the random number table method.The control group was 22 males,21 females,aged(53.39±5.23)years old,the research group was 23 males and 20 females,aged(53.29±5.15)years old,the control group was given anisodamine injection 10mg/time,and the research group was given anisodamine injection 20mg/time.The analgesic effects,pain mediators,stress indicators,urinary biochemical indicators and incidence of adverse reactions were compared of the two groups.The enumeration data were used χ^(2) test,and the measurement data were used independent samples t test or paired data t test.Results Compared with the control group(74.42%),the total effective rate of analgesia in the research group(93.02%)was higher(P<0.05).After treatment,the levels ofβ-endorphin(β-EP)in the two groups were increased(P<0.05),while the levels of substance P(SP)and prostaglandin E2(PGE2)were decreased(all P<0.05),compared with the control group,β-EP[(20.18±2.75)ng/mL than(16.33±2.82)ng/mL]levels in the research group were higher(P<0.05),SP[(0.36±0.08)μg/mL than(0.57±0.10)μg/mL],PGE2[(42.29±5.03)pg/mL than(57.18±5.53)pg/mL]levels were lower(all P<0.05).After treatment,the levels of norepinephrine(NE),angiotensinⅡ(AngⅡ)and cortisol(Cor)in the two groups were decreased(all P<0.05),compared with the control group,NE[(35.81±2.76)μg/L than(46.13±2.92)μg/L],Ang II[(56.78±3.22)pg/mL than(85.36±5.04)pg/mL],Cor[(153.24±21.19)μg/L than(187.01±20.43)μg/L]in the research group was lower(all P<0.05).After treatment,the levels of uric acid(UA),urinary calcium(UC)and urinary oxalic acid(Ox)in the two groups were decreased(all P<0.05),compared with the control group,UA[(0.39±0.11)mmol/d than(0.52±0.16)mmol/d],UC[(3.79±1.03)mmol/d than(5.44±1.29)mmol/d],Ox[(2.49±0.73)mmol/d than(3.85±1.06)mmol/d]in the research group was lower(all P<0.05).In the incidence of adverse reactions between the research group and the control group(9.30%than 6.98%),there was no statistical significance difference(P>0.05).Conclusion Anisodamine injection 20 mg/time for patients with ureteral calculus colic can improve the analgesic effect,regulate the levels of pain mediators,stress indicators and urinary biochemical indicators,and the medication is safe.