Rahman Md Jawaid, Faridi M Shazib, Mibang Naloh, Singh Rajendra Sinam
Department of Urology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Arab J Urol. 2017 Dec 24;16(2):245-249. doi: 10.1016/j.aju.2017.11.012. eCollection 2018 Jun.
To compare the efficacy of tamsulosin, silodosin, and silodosin plus tadalafil as medical expulsive therapy (MET) for distal ureteric calculi.
In all, 120 patients who met the inclusion criteria were randomised into one of three treatment arms: tamsulosin (Group A), silodosin (Group B), and silodosin plus tadalafil (Group C). The drugs were given for a maximum of 4 weeks. The primary endpoint was the stone expulsion rate and secondary endpoints were stone expulsion time, number of pain episodes, and side-effects associated with MET. The follow-up period was for 4 weeks, after which ureteroscopic lithotripsy was done to remove any stones that were not expelled.
There was a statistically significantly higher stone expulsion rate in Group C (90%) as compared to groups A (57.5%) and B (77.5%) with a shorter mean time to stone expulsion. Also, there were statistically fewer pain episodes in Group C as compared to groups A and B. There were no serious side-effects.
The present study concludes that the combination of silodosin and tadalafil increases the ureteric stone expulsion rate and decreases the expulsion time significantly. This combination provided significantly better control of pain without any serious side-effects.
比较坦索罗辛、西洛多辛以及西洛多辛联合他达拉非作为远端输尿管结石药物排石疗法（MET）的疗效。
总共120例符合纳入标准的患者被随机分为三个治疗组之一：坦索罗辛组（A组）、西洛多辛组（B组）和西洛多辛联合他达拉非组（C组）。药物服用最长4周。主要终点是结石排出率，次要终点是结石排出时间、疼痛发作次数以及与药物排石疗法相关的副作用。随访期为4周，之后进行输尿管镜碎石术以清除任何未排出的结石。
与A组（57.5%）和B组（77.5%）相比，C组的结石排出率在统计学上显著更高（90%），且结石排出的平均时间更短。此外，与A组和B组相比，C组的疼痛发作次数在统计学上更少。未出现严重副作用。
本研究得出结论，西洛多辛和他达拉非联合使用可提高输尿管结石排出率，并显著缩短排出时间。这种联合用药能显著更好地控制疼痛，且无任何严重副作用。
