Sarin S K, Sachdev G, Mishra S P, Sundaram K R, Shrivastwa A, Talukdar V, Broor S L
Department of Gastroenterology and Biochemistry, G.B. Pant Hospital, New Delhi, India.
Digestion. 1988;41(2):101-7. doi: 10.1159/000199738.
There are few studies available comparing the efficacy of loop and distal diuretics and a combination of the two groups, in the treatment of ascites due to liver disease. Thirty-seven nonazotemic cirrhotic patients with ascites were randomly allocated to receive for 2 weeks bumetanide (group A, n = 13), spironolactone (group B, n = 12) or a combination of the two drugs (group C, n = 12) after a 5-day stabilization period. The response to the treatment was 69, 42 and 83% in groups A, B and C, respectively; the difference was not significant. Hypokalemia was seen in 4 patients of group A and mild hyperkalemia in 2 patients of group B. Electrolyte disturbances were minimal in patients of group C. The response to diuretic treatment was prompt in groups A and C. It can be concluded that a combination of loop and distal diuretics is superior to a one-drug regimen in achieving a rapid and better diuretic response with fewer side effects.
很少有研究比较袢利尿剂和远端利尿剂以及两组联合用药在治疗肝病腹水方面的疗效。37例无氮质血症的肝硬化腹水患者在经过5天的稳定期后，被随机分配接受2周的布美他尼治疗（A组，n = 13）、螺内酯治疗（B组，n = 12）或两种药物联合治疗（C组，n = 12）。A、B、C三组的治疗有效率分别为69%、42%和83%；差异无统计学意义。A组有4例患者出现低钾血症，B组有2例患者出现轻度高钾血症。C组患者的电解质紊乱最少。A组和C组对利尿剂治疗的反应迅速。可以得出结论，袢利尿剂和远端利尿剂联合使用在实现快速、更好的利尿反应且副作用较少方面优于单一药物治疗方案。
