Akriviadis E A, Hatzigavriel M, Kapnias D, Kirimlidis J, Markantas A, Garyfallos A
University of Southern California Liver Unit, Rancho Los Amigos Hospital, Downey 90242, USA.
Gastroenterology. 1997 Jul;113(1):225-31. doi: 10.1016/s0016-5085(97)70099-4.
BACKGROUND & AIMS: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used to relieve biliary colic. Follow-up was limited in previous studies, and the role of NSAIDs in the natural history of biliary colic has not been clarified. The purpose of this study was to evaluate the efficacy of diclofenac, a potent NSAID, in the the immediate symptomatic relief of biliary colic and the prevention of cholelithiasis-related complications.
Fifty-three patients with cholelithiasis and biliary colic were enrolled in this randomized, double-blind, placebo-controlled study. They received a single 75-mg (3 mL) intramuscular injection of diclofenac (n = 27) or similarly administered 3 mL of saline (n = 26). All patients were followed up for at least 3 days. The effect of either treatment was assessed by changes in the severity of pain and the development of cholelithiasis-related complications.
Complete relief of pain was obtained in 21 diclofenac and in 7 placebo patients; progression to acute cholecystitis was observed in 4 and 11 patients, respectively. Fewer overall complications were observed in the diclofenac group.
In patients with cholelithiasis who present with biliary colic, a single 75-mg intramuscular dose of diclofenac can provide satisfactory pain relief and decrease substantially the rate of progression to acute cholecystitis.
非甾体抗炎药（NSAIDs）已被用于缓解胆绞痛。既往研究的随访时间有限，NSAIDs在胆绞痛自然病程中的作用尚未阐明。本研究的目的是评估强效NSAIDs双氯芬酸在立即缓解胆绞痛症状以及预防胆石症相关并发症方面的疗效。
53例胆石症伴胆绞痛患者纳入了这项随机、双盲、安慰剂对照研究。他们接受了单次75mg（3mL）双氯芬酸肌肉注射（n = 27）或同样注射3mL生理盐水（n = 26）。所有患者至少随访3天。通过疼痛严重程度的变化以及胆石症相关并发症的发生情况评估两种治疗方法的效果。
21例接受双氯芬酸治疗和7例接受安慰剂治疗的患者疼痛完全缓解；分别有4例和11例患者进展为急性胆囊炎。双氯芬酸组观察到的总体并发症较少。
对于出现胆绞痛的胆石症患者，单次肌肉注射75mg双氯芬酸可提供满意的疼痛缓解，并大幅降低进展为急性胆囊炎的发生率。
