比较坦索罗辛与西洛多辛在输尿管结石药物排石治疗中的疗效。
Comparing the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi.
作者信息
Gupta Sandeep, Lodh Bijit, Singh Akoijam Kaku, Somarendra Khumukcham, Meitei Kangjam Sholay, Singh Sinam Rajendra
机构信息
Senior Resident, Post Doctoral (Mch) Trainee, Department of Urology, RIMS , Imphal, India .
出版信息
J Clin Diagn Res. 2013 Aug;7(8):1672-4. doi: 10.7860/JCDR/2013/6141.3241. Epub 2013 Aug 1.
BACKGROUND
Urolithiasis is a chronic disease of mankind, which has enormous public health importance and it accounts for a substantial economic burden on our society. Hence, it becomes all the more important to formulate cheaper and easier means for treating this condition. The past few years have seen a number of drugs being introduced and successfully used in the medical expulsion therapy of small, uncomplicated ureteral calculi, with each drug claiming to provide better results than the others. Ours is perhaps the first study which has compared the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi.
AIMS
To compare the efficacy of tamsulosin (0.4mg) vs silodosin (8mg), both in terms of the stone expulsion rate and the time to stone expulsion.
SETTINGS AND DESIGN
A prospective and a randomized controlled study was conducted in the Department of Urology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India.
MATERIAL AND METHODS
From February to August 2012, 100 patients who were between the age group of 18-50 years, who had unilateral, uncomplicated middle or lower ureteral stones </= 1cm were enrolled and they were divided into two groups. Group 1 received tamsulosin (0.4mg) daily, whereas Group 2 received silodosin (8mg) daily for a maximum period of 4 weeks. The patients were followed up weekly or biweekly with imaging studies. The primary endpoint was the stone expulsion rate and the secondary endpoints were the stone expulsion time, the rate of the interventions and the side effects.
STATISTICAL ANALYSIS
The statistical analysis was performed by using the Student's t-test and the Chi-squared test. A p value of < 0.05 was considered to be statistically significant. The SPSS-16 software was used for the statistical analysis of the data.
RESULTS
A spontaneous stone expulsion was observed in 58% of the patients in group 1 and in 82% of the patients in Group 2, which was statistically significant. There was also a significant difference between the groups with regards to the mean stone expulsion time. A lower analgesic use was found in Group 2.
CONCLUSION
In our study, silodosin was found to be clinically superior to tamsulosin, both in terms of the stone expulsion rate and the stone expulsion time.
背景
尿石症是一种人类慢性疾病，具有重大的公共卫生意义，给社会带来了沉重的经济负担。因此，制定更便宜、更简便的治疗方法变得尤为重要。在过去几年中，有多种药物被引入并成功用于小型、非复杂性输尿管结石的药物排石治疗，每种药物都宣称比其他药物效果更好。我们的研究可能是第一项比较坦索罗辛和西洛多辛在输尿管结石药物排石治疗中疗效的研究。
目的
比较坦索罗辛（0.4毫克）与西洛多辛（8毫克）在结石排出率和结石排出时间方面的疗效。
设置与设计
在印度曼尼普尔邦英帕尔地区医学科学研究所（RIMS）泌尿外科进行了一项前瞻性随机对照研究。
材料与方法
2012年2月至8月，招募了100名年龄在18至50岁之间、患有单侧、非复杂性中下段输尿管结石且结石大小≤1厘米的患者，并将他们分为两组。第一组患者每天服用坦索罗辛（0.4毫克），而第二组患者每天服用西洛多辛（8毫克），最长服用4周。通过影像学检查对患者进行每周或每两周一次的随访。主要终点是结石排出率，次要终点是结石排出时间、干预率和副作用。
统计分析
采用学生t检验和卡方检验进行统计分析。p值<0.05被认为具有统计学意义。使用SPSS - 16软件对数据进行统计分析。
结果
第一组58%的患者结石自行排出，第二组82%的患者结石自行排出，差异具有统计学意义。两组在平均结石排出时间方面也存在显著差异。第二组的镇痛药物使用量较低。
结论
在我们的研究中，发现西洛多辛在结石排出率和结石排出时间方面在临床上均优于坦索罗辛。
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