Kapoor D A, Weitzel S, Mowad J J, Melanson S, Gillen J
Department of Urology, Geisinger Medical Center, Danville, Pennsylvania.
J Urol. 1989 Dec;142(6):1428-30. doi: 10.1016/s0022-5347(17)39117-6.
To determine the effects of indomethacin suppositories in the relief of acute colic and prevention of recurrent colic, we instituted a prospective double-blind, placebo-controlled protocol. Patients were randomized to receive either 50 mg. indomethacin or placebo suppositories every 8 hours and all patients received prescriptions for supplemental narcotics to be used on an as needed basis. Relief of colic was assessed by counting the total number of supplemental narcotics used by each patient per 24 hours during the study period, which was defined as until passage of the calculus or 5 days. There were 41 patients entered into the study protocol and complete followup was available for 26. Mean calculus size was 3.4 mm. in the indomethacin group versus 3.1 mm. in the placebo group. All 13 patients in the control group had recurrent episodes of colic and 8 of these 13 had more than 1 recurrent episode. Five patients in the placebo group required admission to the hospital for control of pain. In contrast, only 4 of the 13 patients in the treatment group had colic and only 1 had more than 1 episode of colic. No patient in the active drug group required admission to the hospital for control of pain. Over-all the ratio of supplemental narcotic used by the placebo group versus the indomethacin group was 7.6:1 (p less than 0.005). The mean interval time to passage of the calculus was slightly lower in the indomethacin group (89 versus 82 hours) but this difference was not statistically significant (p greater than 0.10). Our data strongly support the use of indomethacin suppositories in the prevention of recurrent colic secondary to ureteral calculi.
为确定吲哚美辛栓剂缓解急性绞痛及预防复发性绞痛的效果，我们制定了一项前瞻性双盲、安慰剂对照方案。患者被随机分组，每8小时接受50毫克吲哚美辛或安慰剂栓剂治疗，所有患者均按需开具了补充性镇痛药的处方。通过计算每位患者在研究期间每24小时使用的补充性镇痛药总数来评估绞痛缓解情况，研究期定义为结石排出或5天。共有41名患者进入研究方案，其中26名患者有完整的随访记录。吲哚美辛组结石平均大小为3.4毫米，安慰剂组为3.1毫米。对照组的13名患者均有复发性绞痛发作，其中13名中有8名发作不止一次。安慰剂组有5名患者因疼痛控制需要住院治疗。相比之下，治疗组的13名患者中只有4名出现绞痛，只有1名发作不止一次。活性药物组没有患者因疼痛控制需要住院治疗。总体而言，安慰剂组与吲哚美辛组使用补充性镇痛药的比例为7.6:（p小于0.005）。吲哚美辛组结石排出的平均间隔时间略短（89小时对82小时），但差异无统计学意义（p大于0.10）。我们的数据有力地支持了吲哚美辛栓剂用于预防输尿管结石继发的复发性绞痛。
