双氯芬酸钠栓用于肾绞痛患者的治疗效果观察

目的：探讨和研究双氯芬酸钠栓用于肾绞痛患者的临床疗效。方法96例肾绞痛患者采用随机分组的方式分为两组,对照组48例采用常规治疗措施,即给予间苯三酚联合山莨菪碱治疗,观察组48例则在对照组治疗基础上加用双氯芬酸钠栓治疗,治疗结束后统计并对比疗效。结果从两组患者疗效来看,观察组患者的总有效率为85.4%（41/48）,对照组的总有效率为62.5%（30/48）,观察组显著优于对照组,差异具有统计学意义（P〈0.05）。结论双氯芬酸钠栓在治疗肾绞痛患者方面的疗效显著,能够迅速缓解患者症状,联合常规治疗能够有效提高疗效,值得在临床上推广和应用。     

双氯酚酸钠直肠内上药治疗妇科术后疼痛500例的临床体会

目的：观察双氯酚酸钠直肠内上药治疗妇科术后疼痛的临床效果。方法：应用药品,药量为50ml 1枚,应用剂量1～2枚,可反复应用,患者感觉疼痛不能忍耐时即用,可同时用2枚,应用部位由肛门推入直肠内约5em处。结果：500例直肠上药双氯酚酸钠栓80％,为1次上2枚,术后止痛效果非常满意。结论：双氯酚酸钠栓用于妇产科临床手术患者的术后止痛、排气退热等效果确切,安全可靠。     

对乙酰氨基酚栓与双氯酚酸钠栓治疗小儿急性发热的对比研究

目的对比对乙酰氨基酚栓与双氯酚酸钠栓治疗小儿急性发热的疗效与安全性,探讨后者临床应用优势。方法将我院收治的145例急性发热小儿依据退热给药方式差异予以分组,其中72例给予对乙酰氨基酚栓治疗设为对照组,其余73例采用双氯酚酸钠栓治疗设为观察组,对比两组用药后疗效、再次用药例数与不良反应情况。结果对照组患儿退热效果明显不及观察组(P<0.05);再次用药情况观察组例数明显较少(P<0.05);两组不良反应差异不具显著性(P>0.05)。结论双氯酚酸钠栓应用于急性发热患儿退热,具见效快、维持时间长、用药方便且无明显不良反应等优点,深具临床推广价值。     

双氯酚酸钠栓治疗前列腺气化切除术后早期排尿困难的研究

目的对比单用抗感染治疗与抗感染＋双氯酚酸钠栓治疗行TUVP术拔除导尿管后早期排尿困难、尿痛症状的疗效。方法将19例出现该并发症的患者随机分为实验组与对照组;观察排尿困难及尿痛缓解时间两项指标。结果实验组两项时间指标均较对照组短,且差异具有统计学意义（P〈0.05）。结论联合用药较单予抗感染治疗能较快缓解患者排尿困难和尿痛症状。     

两种止痛栓在人工流产术中的作用比较

目的探讨双氯酚酸钠栓与萘普生栓在人工流产术中对宫颈的松弛软化和镇痛作用的比较。方法对照组115例患者术前由术者本人或护士将萘普生栓1枚塞入肛门内3～4cm处,30min后开始手术。观察组135例患者塞入双氯酚酸钠栓1枚,方法同上。结果观察组宫颈明显软化,易扩张,两组比较差异有统计学意义(P<0.05)。术中观察组疼痛强度明显小于对照组(P<0.05)。结论双氯酚酸钠栓在人工流产术中对宫颈的松弛软化和镇痛作用明显优于萘普生栓。     

双氯酚酸钠栓联合宫腔宫颈表面麻醉在人工流产术中的应用及观察

目的探讨双氯酚酸钠栓联合宫腔宫颈表面麻醉在人工流产术中镇痛效果、安全性及可行性。方法拟行人工流产手术患者120例,随机分为实验组和对照组,各60例,实验组术前肛塞双氯酚酸钠栓,术中用0.25%布比卡因＋1%利多卡因混合液于宫腔、宫颈表面麻醉下行人工流产术;对照组非麻醉下行人工流产术。观察两组临床效果。结果实验组在人流术中镇痛效果明显优于对照组,差异具有统计学意义（P〈0.05）;宫颈松弛度、人工流产综合征等不良反应发生率优于对照组,差异具有统计学意义（P〈0.05）。结论应用双氯酚酸钠栓联合宫腔、宫颈表面麻醉在人工流产术中镇痛效果确切,可明显减轻患者术中疼痛、降低手术并发症的发生率,方法简单、安全、可靠,值得临床推广应用。     

应用双氯芬酸钠栓联合黄体酮治疗肾绞痛疗效观察

2006年10月至2010年3月我院应用双氯芬酸钠栓联合黄体酮治疗肾绞痛患者178例,显效107例,有效65例,无效6例,总有效率96．7％（172／178）。双氯芬酸钠栓联合黄体酮治疗肾绞痛,效果较好,不良反应较少,二者有协同作用,值得临床推广应用。     

阿托品联合异丙嗪治疗肾绞痛临床观察

目的:阿托品联合异丙嗪与杜冷丁治疗肾绞痛效果及不良反应比较。方法109例肾绞痛病人随机分为两组,分别使用阿托品联合异丙嗪及哌替啶治疗,观察镇痛效果及不良反应。结果治疗组总有效率67.9%,对照组总有效率94.3%。两组总有效率比较差异有显著意义(P<0.01)。治疗组20例(35.7%)出现不良反应,对照组有5例(7.15%)出现不良反应,两组不良反应发生率比较差异有显著意义(P<0.05)。结论在急诊肾绞痛止痛时,阿托品联合异丙嗪不能取代杜冷丁,杜冷丁优于前者。     

无痛人工流产600例临床分析

目的探讨无痛人工流产的安全性、有效性。方法选择600例要求人流术的患者分别在人工流产中使用静脉推注丙泊酚、肛塞双氯酚酸钠栓两种止痛方法进行比较。结果丙泊酚在镇痛效果上优于双氯酚酸钠栓(P<0.05)。结论静脉推注丙泊酚麻醉下人工流产安全、有效,值得推广。     

双氯芬酸钠栓在肾绞痛中的应用

目的观察双氯芬酸钠栓治疗结石性肾绞痛的疗效,提高临床的治疗效果以及应用。方法选择2011年3月至2012年6月到我院就诊的180例肾绞痛患者,将所有患者分为两组:对照组和双氯芬酸钠栓治疗组,各组为90例病患,分别观察患者在治疗前后的疗效,观察使用杜冷丁疗效的差异。结果在经过治疗后,将对照组与双氯芬酸钠栓剂组进行比较,有明显的差异。结论双氯芬酸钠栓在治疗肾绞痛的应用中,效果良好,对病患的病情有所帮助,而且患者对杜冷丁的依赖性减少,有助于提高临床的治疗水平。     

山莨菪碱,间苯三酚分别联合双氯芬酸钠利多卡因,异丙嗪治疗肾绞痛的效果比较

目的观察山莨菪碱,间苯三酚分别联合双氯芬酸钠利多卡因,异丙嗪治疗肾绞痛的疗效及安全性。方法将我科自2010年7月至2012年6月488例明确诊断为结石性肾绞痛的患者,分成4个治疗组,分别为山莨菪碱注射液加双氯芬酸钠利多卡因注射液治疗组(A组)、间苯三酚注射液加双氯芬酸钠盐酸利多卡因治疗组(B组)、山莨菪碱加异丙嗪注射液治疗组(C组)、间苯三酚加异丙嗪治疗组(D组),于治疗后30min、60min观察不同组间的止痛效果,副作用及24h复发率。结果 A组总有效率92.0%,B组总有效率96.3%,C组总有效率93.2%,D组总有效率95.1%;A组副作用发生率11.7%,B组副作用发生率5%,C组副作用发生率12.5%,D组副作用发生率8.7%;A组24h复发率10.2%,B组24h复发率7.5%,C组24h复发率9%,D组24h复发率8.7%。结论 B组镇痛效果好,副作用少,24h复发率低。     

双氯芬酸钠栓剂直肠给药治疗结石性肾绞痛效果分析(附236例分析)

目的了解双氯芬酸钠栓剂对结石性肾绞痛的治疗效果。方法回顾性分析我院急诊科近5年收治的236例急性肾绞痛病人资料，所有病例分为对照组和双氯芬酸钠栓剂组，分别观察治疗后2小时、8小时、24小时后的治疗效果，并比较两组使用杜冷丁的例数差异。结果治疗后2小时、8小时，双氯芬酸钠栓剂组与对照组比较，有显著性差异（P〈0．05）；治疗后24小时，两组比较无显著性差异（P〉0．05）。两组使用杜冷丁的例数差异有统计学意义（P〈0．05）。结论双氯芬酸钠栓剂可应用于急性肾绞痛的治疗，效果优于常规治疗，且减少了杜冷丁的使用。     

Physicochemical characterization and<Emphasis Type="Italic">in vivo</Emphasis> evaluation of thermosensitive diclofenac liquid suppository

Liquid suppository systems composed of poloxamers and bioadhesive polymers were easy to administer to the anus and mucoadhesive to the rectal tissues without leakage after the dose. However, a liquid suppository containing diclofenac sodium could not be developed using bioadhesive polymers, since the drug was precipitated in this preparation. To develop a liquid suppository system using sodium chloride instead of bioadhesive polymers, the physicochemical properties such as gelation temperature, gel strength and bioadhesive force of various formulations composed of diclofenac sodium, poloxamers and sodium chloride were investigated. Furthermore, the pharmacokinetic study of diclofenac sodium delivered by the liquid suppository was performed. Diclofenac sodium significantly increased the gelation temperature and weakened the gel strength and bioadhesive force, while sodium chloride did the opposite. The liquid suppositories with less than 1.0% of sodium chloride, in which the drug was not precipitated, were inserted into the rectum without difficulty and leakage. Furthermore, liquid suppository gave significantly higher initial plasma concentrations and faster Tmax of diclofenac sodium than did solid suppository, indicating that drug from liquid suppository could be absorbed faster than that from solid one in rats. Our results suggested that a thermosensitive liquid suppository system with sodium chloride and poloxamers was a more physically stable, convenient and effective rectal dosage form for diclofenac sodium.     

双氯芬酸钠中空栓的制备及质量控制

目的:制备双氯芬酸钠中空栓并建立其质量控制方法。方法:以混合脂肪酸甘油酯为基质制备中空栓,采用紫外分光光度法测定其中主药的含量。结果:所制备制剂为乳白色栓剂;双氯芬酸钠检测浓度的线性范围为5～25μg·mL-1(r=0.9997),平均回收率为102.04%(RSD=1.08%)。结论:该制剂制备工艺简便可行,质量稳定可控。     

双氯芬酸钠栓和坦索罗辛及两药联用治疗输尿管远端结石的疗效比较

目的：比较双氯芬酸钠栓和坦索罗辛及两药联用治疗输尿管远端结石的效果。方法：将输尿管远端结石患者150例,随机分为A组、B组和C组,各50例,A组给予双氯芬酸钠栓治疗,B组给予坦索罗辛胶囊治疗;C组给予两种药物联合治疗。以结石排出及疼痛发作情况为主要的比较指标,以结石排出或治疗2周为观察终点。结果：A、B、C 3组结石排出例数分别为30例、32例、43例;A、B、C组用药后肾绞痛的发作例数分别为14例、17例、6例,均具有统计学差异（P＜0.05）;A、B、C组不良反应发生例数分别为5例、6例、8例,无统计学差异（P＞0.05）。结论：双氯芬酸钠栓和坦索罗辛两种药物联用时可以提高排石效果,缩短排石时间,减少肾绞痛发作,而且不良反应并没有明显增加,建议两种药物联用治疗输尿管远端结石。     

Effect of sodium chloride on the gelation temperature, gel strength and bioadhesive force of poloxamer gels containing diclofenac sodium

Liquid suppository systems composed of poloxamers and bioadhesive polymers were easy to administer to the anus and mucoadhesive to the rectal tissues without leakage after the dose. However, a liquid suppository system containing diclofenac sodium could not be developed using bioadhesive polymers, since the drug was precipitated in this preparation. To develop a liquid suppository system using sodium chloride instead of bioadhesive polymers, the physicochemical properties such as gelation temperature, gel strength and bioadhesive force of various formulations composed of diclofenac sodium, poloxamers and sodium chloride were investigated. The mixtures of P 407 (15%) and P 188 (15-20%) existed as a liquid at room temperature, but gelled at physiological temperature. Diclofenac sodium significantly increased the gelation temperature and weakened the gel strength and bioadhesive force, while sodium chloride did the opposite. Furthermore, the poloxamer gels with less than 1.0% of sodium chloride, in which the drug was not precipitated, were inserted into the rectum of rabbits without difficulty and leakage, and retained in the rectum of rats for at least 6 h. Our results suggested that a thermosensitive liquid suppository system with sodium chloride and poloxamers was a more physically stable and convenient rectal dosage form for diclofenac sodium.     

Assessment of dose-dependent reproductive toxicity of diclofenac sodium in male rats

Diclofenac sodium is widely used in the non-steroidal anti-inflammatory drug in the treatment of pain and inflammation. It is also particularly associated with its adverse effects on avian fauna and linked to environmental issues. The present study was aimed to assess the dose-dependent toxicity of diclofenac sodium on a male reproductive system of rats. Four groups of healthy adult fertile male rats were administered with saline (control) or 0.25?mg/kg, 0.50?mg/kg and 1.0?mg/kg of diclofenac sodium, respectively for 30 days. Alterations in body and organ weight, sperm and testicular cell population dynamics, serum biochemistry, histopathology, and hematology were investigated as per aimed objectives. Diclofenac sodium treatment significantly (p?≤?0.001) reduced weights of testis, epididymis, ventral prostate and seminal vesicle. Sperm count, sperm density (in epididymis and testis), sperm motility and testicular cell population dynamics were lowered in a dose-dependent manner. Administration of diclofenac exhibited varying degrees of degeneration testis, abnormal histo-architectures, and shrinkages in seminiferous tubules, particularly in higher doses. Diclofenac sodium treatments also altered hepatic and renal function parameters significantly. In conclusion, it may claim that diclofenac sodium treatment altered reproductive metabolic status, androgenic activities and histo-architecture of the testis of male rats and induced hepatotoxicity and renal toxicity.     

双氯芬酸钠贴片体外释放度测定

目的：建立双氯酚酸钠释放度测定方法。方法：采用0．5％十二烷基硫酸钠为溶出介质．照分光光度法在不同时间点测定样品中双氯酚酸钠的释放度。结果：贴片体外释放度研究表明双氯芬酸钠体外释药随时间为一递增过程,符合Higuchi方程。结论：本方法药物溶出均匀,操作方便,重现性好,适合于双氯芬酸钠贴片释放度测定。     

Analgesic effects of diclofenac suppository and injection after preoperative administration

Diclofenac sodium (100 mg) has been introduced in the Caribbean as a suppository formulation. In a randomized single-blind (observer-blind) clinical trial, the postoperative analgesic efficacy of diclofenac administered either as a conventional intramuscular injection (75 mg) or as the available suppository formulation (100 mg) was studied in 44 adult male patients undergoing herniorrhaphy in same day surgery. Diclofenac was administered preoperatively at induction of anesthesia to patients (grades ASA I and II) after they had given informed consent. Evaluation of analgesia on the visual analog scale (VAS) did not differ significantly between the two treated groups at three assessment times: on admission to the recovery room, the postoperative ward and at discharge. The times for requests for additional analgesia and the number of patients requesting further analgesia did not differ. Patients who received the suppository were discharged earlier than those who received the injection (40 min vs. 65 min p = 0.02). This preliminary study of the two marketed formulations of diclofenac demonstrated that both preparations provided equivalent analgesia but patients who received the suppository preparation were discharged earlier.     

A multi-centre comparative study of diclofenac sodium and a dipyrone/spasmolytic combination, and a single-centre comparative study of diclofenac sodium and pethidine in renal colic patients in India

A single-blind, randomized clinical trial was carried out to compare the analgesic effectiveness in patients with renal colic of single intramuscular doses of diclofenac sodium (75 mg) versus a dipyrone (1 g)/spasmolytics combination, and diclofenac sodium (75 mg) versus pethidine (75 mg). The first study involved three centres, the second study one centre. In total, 107 patients were treated with diclofenac sodium, 85 with dipyrone/spasmolytics, and 25 with pethidine. Assessments were made during the first hour after drug administration of the degree of pain relief, the severity of pain using a visual analogue scale, and the duration of analgesia. A global assessment of treatment efficacy was made by the participating physicians at the end of the study period. Patients treated with diclofenac sodium showed an earlier onset of analgesia and a higher incidence of total pain relief compared to those treated with dipyrone/spasmolytics or pethidine. Although the mean duration of analgesia was only slightly greater in the diclofenac sodium group than in the dipyrone/spasmolytics group, a significantly longer effect was seen when diclofenac sodium was compared with pethidine (p less than 0.01). Pain severity assessments revealed that diclofenac sodium caused a significantly greater improvement in pain after 60 minutes compared to dipyrone/spasmolytics (p less than 0.05) and after 30 minutes compared to pethidine (p less than 0.05). Global efficacy assessments by the physician rated diclofenac sodium as significantly superior to dipyrone/spasmolytics (p less than 0.01) and pethidine (p less than 0.001). Moreover, diclofenac sodium was better tolerated than either of the comparative treatments. The results indicate that intramuscular diclofenac sodium is a useful alternative to the drugs commonly used in India in the treatment of renal colic.