雷贝拉唑对胃溃疡患者胃内pH值的影响

The effect of rabeprazole on gastric pH in patients with gastric ulcer

目的 评价顿服雷贝拉唑 10mg对胃溃疡患者的抑酸效果和症状缓解情况 ,并以奥美拉唑 2 0mg作为对照。 方法 采用随机、平行、双盲临床对照研究 ,患者随机进入雷贝拉唑组和奥美拉唑组。结果 (1)两组用药后症状均明显改善 ,但治疗 1d后症状改善的程度差异无显著性 (P >0 0 5 ) ;(2 )两组抑酸药物的起效时间均在用药后 2h ;用药后 1h和 2h ,两组患者胃内pH值差异无显著性 (P >0 0 5 ) ;(3)雷贝拉唑组 2 4h总的、夜间 pH >4及夜间 pH >3的百分比明显高于奥美拉唑组(P <0 0 5 ) ,而白天pH >4和 pH >3及总的 pH >3的百分比两组之间差异无显著性 (P >0 0 5 ) ;(4 )雷贝拉唑组白天、夜间 pH >4及 2 4h总的、白天和夜间pH >3超过 30 %的百分率明显高于奥美拉唑组 (P <0 0 5 ) ,而只有总的pH >4超过 30 %的百分率 ,两组之间比较差异无显著性 (P >0 0 5 ) ;(5 )雷贝拉唑组无反应率明显低于奥美拉唑组 (7 8%比 16 4 % ) ,两组比较差异有显著性 (P <0 0 5 )。结论 雷贝拉唑顿服能有效缓解消化性溃疡症状 。

Objective To evaluate the effect of a single dose of rebeprazole (RAB) versus omeprazole (OME) on acid suppression and symptom relief in patients with gastric ulcer. Methods In this randomized, paralleled, double-blind, controlled study, 177 patients with active gastric ulcer confirmed by endoscopy received a single dose of either RAB 10 mg (n=89) or OME 20 mg (n=88). Using 24 h pH monitoring, the percentage of time with intragastric pH>3 and pH>4 was calculated for daytime (08:30-21:00), night-time (21:00-08:30) and total 24 h period. The symptoms improvement was analyzed before and after using RAB and OME. Results (1) There were no differences in improvement of symptoms between two groups (P>0.05). (2) The percentage of time with pH>3 and pH>4 at night-time, and (pH>4) in the total 24 h period were significantly higher with RAB than with OME (P<0.05). (3) The percentage of patients with pH>over 30% of daytime, night-time and 24 h total period was significantly higher with RAB than with OME, also as intragastric pH>4 over 30% of daytime and night-time. (4) Percentage of poor responders to acid suppression with RAB (pH>3 for <30% of the 24 h period) was significantly lower compared with OME (7.8% vs 16.4%,respectively, P<0.05). Conclusions One dose of RAB (10 mg) and OME (20 mg) could improve symptoms in patients with gastric ulcer, however RAB provides superior acid suppression compared with OME , especially on night-time period.