A multicentre, prospective, randomized trial: comparative efficacy of tamsulosin and nifedipine in medical expulsive therapy for distal ureteric stones with renal colic

作者:Ye, Zhangqun; Yang, Huan; Li, Hong; Zhang, Xiaochun; Deng, Yaoliang; Zeng, Guohua; Chen, Lingwu; Cheng, Yue; Yang, Jianggen; Mi, Qiwu; Zhang, Yonghai; Chen, Zhong; Guo, Hui; He, Wei; Chen, Zhiqiang*
来源:BJU International, 2011, 108(2): 276-279.
DOI:10.1111/j.1464-410X.2010.09801.x

摘要

OBJECTIVE @@@ To determine the comparative efficacy of tamsulosin and nifedipine in medical expulsive therapy (MET) for distal ureteric stones with renal colic. @@@ PATIENTS AND METHODS @@@ We evaluated the comparative efficacy of tamsulosin and nifedipine in MET in a prospective randomized trial of 3189 outpatients from 10 centres in China. @@@ Eligible patients randomly received tamsulosin or nifedipine. Efficacies of the two agents in MET were compared at 4 weeks. @@@ The primary endpoint was overall stone-expulsion rate. @@@ Secondary endpoints were stone-expulsion time, rate of pain relief therapy, mean analgesic consumption for renal colic recurrence, and side-effects incidence. @@@ RESULTS @@@ Stone-expulsion rates in the tamsulosin group (group 1) were greater than those in the nifedipine group (group 2; P < 0.01). @@@ There was a significant variation in stone-expulsion rates and times between groups 1 and 2 (P < 0.01); with improvements in stone-expulsion rate and time significantly better in group 1 than in group 2. @@@ There was a significant variation in the rate of pain relief therapy for renal colic recurrence between groups 1 and 2 (P < 0.01); patients in group 1 required significantly less analgesics than those in group 2 (P < 0.01). @@@ There were no statistically significant differences in side-effects incidence between the groups. @@@ CONCLUSIONS @@@ Administration of tamsulosin and nifedipine in MET was determined to be safe and effective for distal ureteric stones with renal colic. @@@ Tamsulosin was significantly better than nifedipine in relieving renal colic and facilitating ureteric stone expulsion.