Preminger G M, Harvey J A, Pak C Y
J Urol. 1985 Oct;134(4):658-61. doi: 10.1016/s0022-5347(17)47371-x.
It generally is believed that conservative measures of high fluid intake and dietary modification in the setting of a stone clinic could favorably influence the course of renal stone disease. To establish the effect of specific medical treatment from the stone clinic effect, we compared the results of potassium citrate therapy to those of 11 reported conservative or placebo trials. The 54 patients receiving potassium citrate chosen for this comparison had mild to moderately severe stone disease (less than 1 stone per patient per year), similar to that encountered in conservative placebo trials (mean 0.54 stones per patient per year). New stone formation was virtually eliminated by potassium citrate therapy (a decrease from 0.52 to 0.02 stones per patient per year, a remission rate of 96 per cent, p less than 0.001), whereas it continued in 39 per cent of the patients during conservative or placebo trials. However, in patients participating in conservative or placebo trials new stone formation decreased by only 54 per cent (from 0.54 to 0.25 stones per patient per year). The superior response to potassium citrate suggested that this specific medical treatment exerted an additional favorable effect on the course of stone disease above the stone clinic effect.
一般认为，在结石门诊采取高液体摄入量和饮食调整等保守措施，可能会对肾结石疾病的病程产生有利影响。为了从结石门诊的效果中确定特定药物治疗的效果，我们将枸橼酸钾治疗的结果与11项已报道的保守治疗或安慰剂试验的结果进行了比较。此次比较中选取的54例接受枸橼酸钾治疗的患者患有轻度至中度严重的结石疾病（每位患者每年结石少于1块），与保守安慰剂试验中遇到的情况相似（每位患者每年平均0.54块结石）。枸橼酸钾治疗几乎消除了新结石的形成（从每位患者每年0.52块降至0.02块，缓解率为96%，p<0.001），而在保守治疗或安慰剂试验期间，39%的患者仍有新结石形成。然而，在参与保守治疗或安慰剂试验的患者中，新结石形成仅减少了54%（从每位患者每年0.54块降至0.25块）。对枸橼酸钾的更好反应表明，这种特定的药物治疗在结石门诊效果之外，对结石疾病的病程还产生了额外的有利影响。
