奥美拉唑和西咪替丁对十二指肠溃疡病愈合率和复发率影响的对比研究

Effectof omeprazole and cimetidine on ulcerhealing and relapseratein duodenalulcerdisease

目的 对奥美拉唑和西咪替丁对十二指肠溃疡病愈合率和复发率影响的对比研究。方法５３ 例经内镜检查证实的活动性十二指肠溃疡病，随机分成奥美拉唑组和西咪替丁组，先行短程治疗。奥美拉唑每日１ 次，每次２０ｍｇ，治疗４ 周；西咪替丁每次８００ｍｇ，每晚睡前服，治疗４～６ 周。结果 奥美拉唑组和西咪替丁组４ 周溃疡愈合率分别为９２．３ ％（２４／２６ 例） 和６６ ．７％ （１８／２７ 例），西咪替丁组６ 周溃疡愈合率为８５．２％ （２３／２７ 例）。对溃疡愈合的４７ 例进行长程治疗，前者用量是一次口服２０ｍｇ，每周２次；后者是４００ｍｇ，每晚睡前服一次；各用药一年，观察一年内溃疡累积复发率。复发均经内镜检查证实。奥美拉唑组一年内累积复发率为４．２％ （１／２４），西咪替丁组为２６．１％ （６／２３）。结论 推测奥美拉唑组短程治疗时溃疡愈合率高于西咪替丁组而长程治疗时一年累积复发率明显低于西咪替丁组，是奥美拉唑对酸抑制程度强和２４ 小时内抑制酸分泌的持续时间长的缘故。

Objective Fifty three patients with endoscopically proven active duodenal ulcer disease wererandomly allocatedto treatment with omeprazole and cimetidine. Methods Omeprazole was usedin a dose of 20mg p .o.daily and cimetidine 800mg p.o.given assingle dosingatbedtimefor4 weeks.Results Attheend oftheshort term treatment92 .3 %(24/26) ofulcers were healed with omeprazolevs66.7 % (18/ 27) with cimetidine.Anotherfivepatients whoseulcershealed at6 weeks werealsoincludedintheshort term cimetidinetreatmentgroup.After ulcer healing,patients(47 to date) weretreated with omeprazole(20mg, p.o.twicea week) and cimetidine (400mg/day p.o.atbedtime) for one yearlong term maintenancethera py.Duodenalulcerdisease were keptinremissionin allbut1 (4.2% ,1/24) with omeprazoleand 6(26.1 % , 6/23) with cimetidine.Conclusions No major adverse eventsandlaboratory variablesincluding hematology, liverfunction,renalfunction and electrolytes were noted bothin theshort term andin thelong term mainte nance treatment with eitherdrug.Itispossiblethatthegreaterdegreeofsuppression ofgastricacidityandthe prolongedsuppression ofacidity duringthe 24h period areresponsibleforthesignificantly higher ulcerhealingandlowerrelapserate with omeprazolethan with cimetidine.