胃酸缺乏症患者口服药物吸收提高策略的研究进展

Advances in the strategies to enhance oral drug absorption for achlorhydric patients

胃酸缺乏症是一种常见的临床病症,该类患者使用弱碱性药物治疗其他疾病时,口服吸收及疗效常常降低,这引起临床医生和药师的极大关注。笔者通过分析归纳现有文献,对近年来提高胃酸缺乏症患者口服药物吸收策略的最新进展进行综述。目前,选择合适的抗酸药或抑酸药及间隔给药、共服酸性碳酸饮料、预服盐酸盐类物质的固体制剂、应用药剂学微环境pH调控技术构建的新型释药系统产品是逆转低胃酸效应、提高药物口服吸收和生物利用度、保证药物临床疗效的有效手段。其中,基于微环境pH调控技术的新型非pH依赖性口服释药系统有望从根本上解决低胃酸效应,且处方工艺简单、生产成本低、患者依从性好,具有良好的应用前景。

Achlorhydria is a common clinical disease. In achlorhydric patients,the efficacy of weakly basic drugs by oral administration for treating other diseases is always reduced or disappeared,which causes great concern among doctors and pharmacists. We reviewed the recent advances in the strategies of increasing oral absorption in achlorhydric patients. Selection of proper antiacids or acid-reducing drugs and their separate dosing,coadministration of acidic carbonated beverages,pretreatment with solid dosage form of hydrochloric acid salts,and administration of novel oral drug delivery products using microenvironmental pH(pHM） modified technology are the effective methods to reverse the achlorhydric effects,enhance oral drug absorption and bioavailabity,and keep the drug efficacy at present. The novel pH-independent oral drug delivery system using pHMmodified techniques can fundamentally solve the achlorhydric effects with simple formulation and process,low cost of manufacture,good patient compliance,and has broad application prospect.