Lemieux G, Beauchemin M, Gougoux A, Vinay P
Can Med Assoc J. 1978 May 6;118(9):1074-8.
Tienilic acid--2,3-dichloro-4-(2-thienyl-carbonyl)phenoxyacetic acid--is a new diuretic with uricosuric properties. Nineteen patients with moderate arterial hypertension were treated for 5 consecutive weeks in a randomized fashion in a double-blind study with either tienilic acid or hydrochlorothiazide. Blood pressure was significantly reduced and to the same degree with both drugs. In 7 of the 11 patients receiving tienilic acid the daily dose was increased from 250 to 500 mg after 2 weeks, and in 2 of the 8 patients taking hydrochlorothiazide the daily dose was increased from 50 to 100 mg. Because of the potent uricosuric action of tienilic acid the mean serum urate concentration decreased from 6.3 to 3.3 mg/dL in the patients taking the drug. In contrast, the patients receiving hydrochlorothiazide the mean serum urate concentration increased from 6.1 to 7.8 mg/dL. Moderate hypokalemia of almost identical degree (mean serum potassium values 3.6 and 3.5 mmol/L) and mild metabolic alkalosis were observed in both groups. Tienilic acid had a marked hypocalciuric effect, which was of the same magnitude as the observed with hydrochlorothiazide. During the 5 weeks of treatment no significant change in renal or liver function was observed in either group. There were no hematologic complications and the drug was remarkably well tolerated. Tienilic acid, because of its unique character as a diuretic, hypouricemic and antihypertensive agent, should become the preferred drug for the treatment of arterial hypertension.
替尼酸——2,3 - 二氯 - 4 -（2 - 噻吩甲酰基）苯氧基乙酸——是一种具有促尿酸排泄特性的新型利尿剂。在一项双盲研究中，19例中度动脉高血压患者被随机分为两组，分别接受替尼酸或氢氯噻嗪连续5周的治疗。两种药物均可使血压显著降低，且降低程度相同。接受替尼酸治疗的11例患者中，有7例在2周后每日剂量从250毫克增加至500毫克；服用氢氯噻嗪的8例患者中，有2例每日剂量从50毫克增加至100毫克。由于替尼酸具有强大的促尿酸排泄作用，服用该药物的患者平均血清尿酸浓度从6.3毫克/分升降至3.3毫克/分升。相比之下，接受氢氯噻嗪治疗的患者平均血清尿酸浓度从6.1毫克/分升升至7.8毫克/分升。两组均观察到程度几乎相同的中度低钾血症（平均血清钾值分别为3.6和3.5毫摩尔/升）和轻度代谢性碱中毒。替尼酸具有明显的降钙尿作用，其程度与氢氯噻嗪相当。在5周的治疗期间，两组患者的肾功能或肝功能均未观察到显著变化。未出现血液学并发症，且该药物耐受性良好。替尼酸因其作为利尿剂、降尿酸药和抗高血压药的独特特性，应成为治疗动脉高血压的首选药物。
