Brardi Simone, Imperiali Patrizio, Cevenini Gabriele, Verdacchi Tiziano, Ponchietti Roberto
Hemodialysis Unit, Ospedale S. Donato, Arezzo, Italy.
Arch Ital Urol Androl. 2012 Jun;84(2):61-7.
To evaluate by a prospective randomized controlled study the efficacy of the association of potassium citrate and dry extract of couch grass (Agropyrum repens) (CalcoMEV) in renal stone treatment.
50 patients with nephrolithiasis associated with one or more active metabolic alterations that constitute an indication to the use of potassium citrate were randomly divided in two equal unblinded treatment groups. A group of patients was assigned to treatment with the association of potassium citrate and couch grass (at the dose of 24 mEq of potassium citrate and 100 mg of dry extract of Agropyrum repens bis in die) and the other group to potassium citrate (at a dose of 20 mEq ter in die). Each form of main treatment was associated, depending on the results of metabolic basal assessment, to allopurinol and/or an association of amiloride and hydrochlorothiazide and/or pyridoxine. Patients of both groups were advised the same diet based on a reduced intake of sodium, foods rich in oxalate and protein of animal origin, a normalized intake of calcium and an increase in fluid intake (> 2 liters every day).
At the end of the 5-month follow-up period, the group treated with the association of potassium citrate and couch grass showed a significant reduction in the total number of stones (-1.0 +/- 0.2 vs. 0.0 +/- 0.2 stones) and in the larger diameter of the stones (-3.6 +/- 0.9 mm vs. 0.0 +/- 0.8 mm), as well as a statistically significant reduction of uric acid urinary excretion (-164.7 +/- 45.3 vs -38 +/- 42 mg/24 h). No significant differences in the two groups were observed with respect to urinary citrate, oxalate and calcium urinary excretions and urinary pH.
This prospective randomized study demonstrates the superiority of the association of potassium citrate and dry extract of couch grass, in combination with standard pharmacological and dietary treatment, in reducing the number and size of urinary stones with respect to potassium citrate in association with the same pharmacological and dietary regimen.
通过一项前瞻性随机对照研究，评估柠檬酸钾与匍匐冰草（Agropyrum repens）干提取物（CalcoMEV）联合使用在肾结石治疗中的疗效。
50例患有肾结石且伴有一种或多种活跃代谢改变（构成使用柠檬酸钾指征）的患者被随机分为两个相等的非盲治疗组。一组患者接受柠檬酸钾与匍匐冰草联合治疗（柠檬酸钾剂量为24 mEq，匍匐冰草干提取物剂量为每日100 mg，分两次服用），另一组接受柠檬酸钾治疗（剂量为每日20 mEq，分三次服用）。根据基础代谢评估结果，每种主要治疗方式均联合使用别嘌醇和/或阿米洛利与氢氯噻嗪联合制剂和/或吡哆醇。两组患者均被建议采用相同饮食，即减少钠、富含草酸盐的食物和动物源性蛋白质的摄入量，使钙摄入量正常化，并增加液体摄入量（每天>2升）。
在5个月的随访期结束时，接受柠檬酸钾与匍匐冰草联合治疗的组结石总数显著减少（-1.0±0.2颗对0.0±0.2颗），结石最大直径显著减小（-3.6±0.9 mm对0.0±0.8 mm），尿酸尿排泄量也有统计学意义的显著降低（-164.7±45.3对-38±42 mg/24 h）。两组在尿枸橼酸盐、草酸盐、钙排泄量及尿液pH值方面未观察到显著差异。
这项前瞻性随机研究表明，在相同的药物和饮食方案下，柠檬酸钾与匍匐冰草干提取物联合使用，相较于单独使用柠檬酸钾，在减少尿结石数量和大小方面具有优势，且联合了标准的药物和饮食治疗。
