硝苯吡啶对消化性溃疡防治作用的实验研究和临床观察

EFFECT OF NIFEDIPINE ON PEPTIC ULCER:EXPERIMENTAL RAT MODELS AND CLINICAL OBSERVATION

在消炎痛和幽门结扎制造的大鼠消化性溃疡模型中。预先给予硝苯吡啶的实验组溃疡发生率、数目.面积以及病理上胃损伤指数明显低于对照组;胃液量及可滴定酸量也明显降低.电镜显示对照组胃粘膜微绒毛损害、毛细血管闭塞、基底膜断裂等。而实验组则示毛细血管扩张、病理损害较轻.临床28例十二指肠溃疡口服硝苯吡啶,另26例相同病情口服丙谷胺.4～5周后复查,溃疡愈合率分别为82%、42%(P<0.01).两组治疗后 BAO、MAO 和PAO 均降低。但组间差异无显著性.结论:(1)硝苯吡啶对消化性溃疡有较好防治作用;(2)其治疗机理除抑制胃酸分泌外,还与改善胃粘膜微循环、强化粘膜屏障有关。

In the experimental rat models of peptic ulcer induced with indocin or pylorus ligation,the rats given nifedipine via gastrogavage demonstrated significant decrease in the ulceration incidence,num- ber,area and gastric lesion indices as well as in the volume of gastric secretion and titercd acid,com- pared with the controls.Obvious damages to microvilli of gastric mucosa,occlusion of capillaries and rupture of basic membranes were found under electronmicroscopes in the controls,while in nifedipine group,dilation of capillaries and less histologic lesion were shown. Clinically,in 54 patients with duodenal ulcer,28 were treated with nifedipine and 26,with proglumide as control.4～5 weeks later,significant higher healing rate(82%)revealed in nifedipine proup than that(42%)in the control.BAO,MAP and PAP were all significan tly decreased in both the two groups but no difference was found between the two.Conclusions:(1)Nifedipine is of value in the treatment of peptic ulcer;(2)The anti-ulcer action of the drug involves inhibition of gastric acid secretion and improvement of mucosal microcirculation and mucosal barrier as well.