非甾体抗炎药相关胃溃疡的预防及治疗

Prevention and treatment of non-steroidal anti-inflammatory drug related gastric ulcer

非甾体抗炎药(non-steroidal anti-inflammatory drugs,NSAIDs)在临床广泛应用,其不良反应主要是胃溃疡的发生。临床使用NSAIDs的医师应了解综合防治非甾体抗炎药相关胃溃疡的方法,包括饮食、生活习惯调整、及时根除幽门螺杆菌(Helicobacter pylori,Hp)、宣教、根据个体危险因素个体化选择用药方案同时进行功能监测。药物而非侵入性操作或手术是主要防治选择。目前,抗溃疡药物主要有抑酸剂、黏膜保护剂、前列腺素类似物等,具体配伍选择及剂量国内尚无权威指南。为全面了解NSAIDs相关胃溃疡的发生情况,本文拟从NSAIDs服用者发生消化性溃疡和黏膜损伤的因素和机制、NSAIDs相关胃溃疡的预防、相关药物的治疗、NSAIDs的应用现状及后期的展望几个方面进行综述。

Non-steroidal anti-inflammatory drugs(NSAIDs)are widely used in clinical practice,and their adverse reactions are mainly the occurrence of gastric ulcer.Clinical use of NSAIDs physicians should understand the comprehensive prevention and treatment of NSAIDS-related gastric ulcers,including diet,lifestyle adjustment,timely eradication of Helicobacter pylori(Hp),education,individualized selection of medication according to individual risk factors and functional monitoring.Drugs rather than invasive procedures or surgery are the main treatment options.At present,anti-ulcer drugs mainly include acid suppressors,mucosal protectants,prostaglandin analogues,etc.,but there is no authoritative guideline for specific compatibility selection and dosage in China.In order to comprehensively understand the occurrence of NSAIDS-related gastric ulcers,this paper intends to review the factors and mechanism of peptic ulcer and mucosal injury in NSAIDs users,prevention strategies of NSAIDS-related gastric ulcers,therapeutic measures of related drugs,current application status of NSAIDs and future prospects.