奥美拉唑和雷尼替丁对十二指肠溃疡病愈合率和复发率影响的对比研究

Contrastive study of the healing and relapse rates in duodenal ulcer disease treated with omeprazole and ranitidine

目的对比奥美拉唑和雷尼替丁治疗十二指肠溃疡病近期愈合率和复发率 ,探索质子泵抑制剂 (PPI)与 H2 受体拮抗剂对防止溃疡病复发的远程疗效。方法 118例经内镜检查证实的活动性十二指肠溃疡患者 ,随机分成奥美拉唑组和雷尼替丁组 ,进行疗效对比。结果奥美拉唑组和雷尼替丁组 4周溃疡愈合率分别为 88.3% (6 8/77)和 6 8.3% (2 8/41) ,雷尼替丁组 6周溃疡愈合率为 90 .2 %(37/41)。对溃疡愈合的 37例进行长程治疗 6～ 12个月 ,观察用药时间内的溃疡累计复发率。奥美拉唑组 1年内累计复发率为 5 .2 %(1/19) ,雷尼替丁组为 16 .6 % (3/16 )。结论奥美拉唑组短程治疗时溃疡愈合率高于雷尼替丁组 ,而长程治疗时 1年累计复发率明显低于雷尼替丁组 ,由于奥美拉唑对酸抑制程度大而且时间长 ,因此 ,临床上可迅速缓解症状 。

Objective To contrast the healing and relapse rates of duodenal ulcer disease (DU) treated with omeprazole and ranitidine and study the remote therapy of proton pump inhibitor (PPI) and H 2 receptor for the prevention of relapse of ulcer.Methods 118 patients with DU confirmed by endoscopic examination were randomly divided into two groups:one treated with omeprazole and the other with ranitidine,and received short term therapy at fist for 4～6 weeks.Results The healing rates of the both groups within 4 weeks were 88.3% (68/77) and 68.3% (28/41) respectively.The ranitidine group enjoyed a healing rate of 90.2% (37/41) within 6 weeks,and the 37 cases with ulcer healed received long term maintenance therapy for 6～12 months.The total relapse rates were counted and confirmed by endoscopic examination during administration.The total relapse rate after one year for the omeprazole group was 5.2% (1/19),while that for the ranitidine group was 16.6%(3/16).Conclusion During the short term treatment,healing rate in omeprazole group was higher than that in the ranitidine group,while during the long term treatment,relapse rate for the omeprazole group was much lower than that for the ranitidine group.Therefore,omeprazole,which has greater degree and prolonged effect of suppression of acidity,can be used clinically for faster relief of the symptoms and for better improvement of the healing.