3种抗胆碱能药物用于急性胆绞痛治疗的比较观察  

Comparison the Effect of Three Anticholinergic Drugs therapy for Acute Biliary Colic

作　　者：刘嗣庭 

机构地区：[1]湖南省怀化市第二人民医院洪江医院传染科,湖南怀化418200

出　　处：《中国医药指南》2011年第5期28-30,共3页Guide of China Medicine

摘　　要：目的比较观察阿托品、山莨菪碱和盐酸戊乙奎醚分别用于治疗急性胆绞痛的疗效。方法选择243例因右上腹部疼痛就诊的患者,行腹部B超检查证实胆囊结石,随机分为阿托品组(A组)、山莨菪碱组(B组)和盐酸戊乙奎醚组(C组),分别肌内注射阿托品1mg、山莨菪碱10mg和盐酸戊乙奎醚1mg,观察记录3组患者各时点的腹痛缓解情况、心率(HR)及平均动脉压(MAP)变化情况和不良反应发生情况。结果 C组T2～T5各时点显效率及有效率均高于A组及B组(P<0.05),A组T3～T5各时点的显效率及有效率高于B组(P<0.05),用药后C组各时点HR及MAP均无明显变化(P>0.05),而A组及B组用药后各时点HR均高于基础值(P<0.05),而MAP无变化(P>0.05),组间比较A组及B组用药后各时点HR均高于C组同时点HR(P<0.05),C组口干、头晕、面部潮红、视物模糊及心悸的发生率均低于A组及B组(P<0.05)。结论抗胆碱能药物能较有效缓解急性胆绞痛,阿托品疗效好于山莨菪碱,但二者均发生一定概率的不良反应,盐酸戊乙奎醚疗效最好且不良反应较少,对心率影响较小,是用于急性胆绞痛治疗较理想的抗胆碱药物。Objective To compare the effect of three anticholinergic drugs therapy for acute billary colic.Methods We chose 243 cases of acute right abdominal pain with proof of cholecystolithiasis by B ultrasound and divided into atropine group（group A）,anisodamine Group（group B） and penehyclidine hydrochloride group（group C）,randomly.We gave atropine 1mg,anisodamine 10mg and penehyclidine hydrochloride 1mg i.m.for each group,then observed abdominal pain relief condition,changes of heart rate（HR） and Mean arterial pressure（MAP） and the incidence of adverse reactions.Results Effective rates of T2～T5 of group C were highest（P0.05）,effective rates of T3～T5 of group A were higher than group B（P0.05）,HR and MAP of group C of each time point were similar（P0.05）,while HR of group A and group B were higher than baseline value（P0.05）,HR of group A and group B were also higher than group C at the same time point（P0.05）,most adverse reactions rates of group C were lower（P0.05）.Conclusion Anticholinergic drugs can relieve acute billary colic effectively atropine is better than anisodamine but also bring some adverse reactions,penehyclidine hydrochloride has the best therapeutic effect with the least adverse reactions,it seldom influences HR,so it is an almost ideal anticholinergic drug for acute billary colic therapy.

关 键 词：胆绞痛 阿托品 山莨菪碱 盐酸戊乙奎醚 抗胆碱能药物 

分 类 号：R575.6[医药卫生—消化系统]