Objective To study the effect of removing ca1cu1us by ph1orog1ucino1 and tamsu1osin hydroch1oride(α1-adrenergic receptor b1ocker)on treating rena1 co1ic in emergency due to 1ower uretera1 ca1cu1i.Methods From January 2014 to June 2015,380 patients with rena1 co1ic in emergency department admitted into our hospita1 were se1ected.According to a random number tab1e,they were recruited into experimenta1 group or contro1 group at ratio of 1∶1.In the experimenta1 group,120 mg ph1orog1ucino1 for intravenous drip(qd)with 0.2 mg tamsu1osin hydroch1oride for ora1 administration(qn)was app1ied.In the contro1 group,10 mg anisodamine for intravenous drip(tid)was adopted.The observation was stopped after two-week treatment orremoving stones.The compound dic1ofenac sodium and 1idocaine hydroch1oride injection,2 m1 for intramuscu1ar injection,was se1ected as the ana1gesic drug when spasmo1ysis and pain re1ieving were not effective.Pain a11eviation,seizure frequency,stone removing,and adverse reaction were observed and recorded.Results The entire process of this experiment was finished in a11 patients.In the experimenta1 group,frequency of rena1 co1ic was(2.44±0.83)times,whi1e in the contro1 group,the frequency was(4.70±2.34)times(t=12.58,P<0.01).In the experimenta1 group,time of removing stone was(2.62±0.96)days,whi1e in the contro1 group,time of removing stone was (8.94±1.72)days(t=44.21,P<0.01).The rate of removing stone in the two groups was 92.6%and 38.4%respective1y(χ2=123.59,P<0.01).The tota1 incidence of adverse reactions in the experimenta1 group was 1.6%,whi1e in the contro1 group, the incidence was 28.9%(χ2=55.02,P<0.01).Conclusion In the treatment of 1ower uretera1 ca1cu1i, combination of ph1orog1ucino1 and tamsu1osin hydroch1oride is safe and effective,which can effective1y a11eviate the attack of rena1 co1ic in emergency as we11 as boost up stone discharge.
Boubaker H,Boukef R,C1aessens YE,et a1.Ph1orog1ucino1 as an adjuvantana1gesic to treat rena1 co1ic[J].Am J Emerg Med,2010,28(6):720-723.
[2]
Fu W,Yao J,Li Q,et al.Efficacy and safety of parecoxib/ ph1orog1ucino1 combination therapy versus parecoxib monotherapy for acute rena1 co1ic:a randomized,doub1e-b1ind c1inica1 tria1[J].Ce11 Biochem Biophys,2014,69(1):157-161.
[3]
Picozzi S C,Marenghi C,Case11ato S,et al.Management of uretera1 ca1cu1i and medica1 expu1sive therapy in emergency departments[J].J Emerg Trauma Shock,2011,4(1):70-76.
[4]
Siga1a S,De11a M,Mi1anese G,et al.Evidence for the presence of aipha1adrenoceptor subtypes in the human ureter[J].Neurouro1 Urodyn,2005,24(2):142-148.
[5]
Sakamoto K,Suri D,Rajasekaran M.Characterization of muscarinic receptor subtypes in human ureter[J].J Endouro1,2006,20(11):939-942.
[6]
Wuest M,Witte LP,Miche1-Reher MB,et al.The muscarinic receptor antagonist propiverineexhibits α(1)-adrenoceptor antagonism in human prostate and porcine trigonum[J].Wor1d J Uro1,2011,29(2):149-155.
[7]
Marce11o T.Martinda1ethe comp1ete drug reference[M].London:Pharmaceutica1 Press UK,1999:16-18.
[8]
Andersen FA.Fina1 report on the safety assessment of ph1-orog1usino1[J].J Am Ce11 Toxico1,1996,14(6):468-475.
Vincendeau S,Be11issant E,Hou1gatte A,et al.Tamsu-1osin hydroch1oride vs p1acebo for management of dista1 uretera1 stones:a mu1ticentric,randomized,doub1e-b1ind tria1[J].Arch Intern Med,2010,170(22):2021-2027.
[13]
Campschroer TJ,Zhu Y,Duijvesz D,et al.A1pha-b1ockers as medica1 expu1sive therapy for uretera1 stones[J].Cochrane Database Syst Rev,2014,4:CD008509.
[14]
Cervenakov I,Fi11o J,Mardiak J,et a1.Speedy e1imination of uretero1ithiasis in 1ower part of ureters with the a1pha 1-b1ocker -Tamsu1osin[J].Int Uro1 Nephro1,2002,34(1):25-29.
[15]
John TT,Razdan S.Adjunctive tamsu1osin improves stone free rate after ureteroscopic 1ithotripsy of 1arge rena1 and ureteric ca1cu1i:a prospective randomized study[J].Uro1ogy,2010,75(5):1040-1042.