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Nephrolithiasis in northeastern Thailand frequently presents with multiple chronic health complaints
(MCHC), namely, myofascial pain, back pain, dyspepsia, arthralgia, headache, fatigue, frank paresthesia,
dysuria, and any of these aggravated by purine-rich food (PRF). We previously reported that long-term
consumption of Orthosiphon aristatus (Blume) Miq. (OA) herbal tea could relieve certain health complaints
and cause some reduction of stone size in nephrolithic patients with MCHC and positive white blood cells
(WBC) in the urine. The objective of this study was to compare the efficacy of OA or OA plus norfloxacin
(NFL) in the treatment of MCHC subjects with negative or positive urine white blood cells. A double-con-
cealed, randomized, controlled trial was conducted in 15 rural villages in Khon Kaen Province from February
through July 2005 on 209 MCHC subjects enrolled and 193 evaluated (75 without WBC and 118 with WBC),
and randomly assigned into 4 groups, as follows: G1 (39), G2 (36), G3 (60) and G4 (58). Placebo with OA
(extract of 1.7 g dried leaves), norfloxacin 400 mg (NFL) and OA+NFL, all in identical capsules, were given to
G1, G2, G3 and G4, respectively. The medications were packed, then their codes were concealed. Every group
was instructed to avoid purine-rich food (PRF) during the two-week treatment period. Therapeutic success,
defined as the reduction of the VAS score 50 percent in 50 percent of the subjects, for each active MCHC
symptom. The results showed subjects in every group reduced their PRF intake during treatments by 90
percent and each active symptom was significantly decreased (p<0.001, Friedman Test); thus, therapeutic
success was reached within two weeks. A statistically significant difference between the groups was not found.
Only the reactive MCHC symptoms of the subjects in G1 (placebo group) did not decrease, while those in the
other groups (G2, G3, G4) significantly decreased (p<0.05, Pearson chi-square). The study concluded that
PRF-restriction significantly reduced MCHC symptoms among all treatment groups within two weeks and
the incidence of the reactive MCHC symptoms of G2, G3 and G4 were significantly reduced in the second
week while they did not decrease in the placebo group (G1).

Key words: norfloxacin, Orthosiphon aristatus, purine-rich food, chronic health complaints, renal stone