质子泵抑制剂：饭前服用比空腹服用能更好地抑制胃酸。
Proton pump inhibitors: better acid suppression when taken before a meal than without a meal.
作者信息
Hatlebakk J G, Katz P O, Camacho-Lobato L, Castell D O
机构信息
Oesophageal Research Laboratory, Department of Medicine, The Graduate Hospital, Philadelphia, Pennsylvania, USA.
出版信息
Aliment Pharmacol Ther. 2000 Oct;14(10):1267-72. doi: 10.1046/j.1365-2036.2000.00829.x.
BACKGROUND
Proton pump inhibitors including omeprazole and lansoprazole inhibit gastric acid secretion by selectively and non-competitively inactivating the H+, K+ ATPase molecules of the parietal cell, but possibly only those that are actively secreting acid. This might imply that stimulation of acid secretion by a meal is necessary for optimal inhibition of gastric secretion.
AIM
To quantify and compare the effect on daytime gastric acidity of omeprazole 20 mg or lansoprazole 30 mg daily taken 15 min before breakfast, with that of the same drug taken without a meal.
METHODS
Twenty-one healthy volunteers were randomized to receive either omeprazole or lansoprazole. They were given the drug for two separate periods of 7 days in randomized order and at least 7 days apart. During one period the study medication was taken before breakfast; during the other it was taken at the same hour, but with no meal until 12:00 hours. Lunch was standardized. On day 7, intragastric pH-metry was performed, starting at 08:00 hours. Tracings were analysed for the 8-h period from 08:00 hours until 16:00 hours with regard to percentage time for which gastric pH was below 4.0 and 3.0, and median gastric pH. Tracings were also analysed after removing the 1 h breakfast period, to exclude the buffering effect of the meal.
RESULTS
When taking the drug with breakfast, the median percentage time for which gastric pH < 4.0 was 17.2 (interquartile range 4.6-45.5), compared with 42.0 (interquartile range 31.4-48.8) when taken without food (P=0.01). Fifteen subjects had better control of gastric acidity when the medication was taken with breakfast. A pH threshold of 3 and median pH showed similar differences. When the breakfast period was removed, the differences were no longer statistically significant.
CONCLUSIONS
When therapy with omeprazole or lansoprazole is indicated, medication should be taken before a meal for optimal control of daytime gastric acidity.
背景
包括奥美拉唑和兰索拉唑在内的质子泵抑制剂通过选择性和非竞争性地使壁细胞的H⁺，K⁺ -ATP酶分子失活来抑制胃酸分泌，但可能仅对那些正在活跃分泌胃酸的分子起作用。这可能意味着进餐刺激胃酸分泌对于最佳抑制胃分泌是必要的。
目的
量化并比较早餐前15分钟每日服用20毫克奥美拉唑或30毫克兰索拉唑对白天胃酸度的影响，与空腹服用相同药物的效果。
方法
21名健康志愿者被随机分为接受奥美拉唑或兰索拉唑治疗。他们按随机顺序在两个不同的7天周期内服用药物，且两个周期至少间隔7天。在一个周期中，研究药物在早餐前服用；在另一个周期中，在同一时间服用，但直到12:00才进食。午餐是标准化的。在第7天，从08:00开始进行胃内pH测量。分析从08:00到16:00这8小时期间胃pH低于4.0和3.0的时间百分比以及胃pH中位数的记录。在去除1小时早餐期后也对记录进行分析，以排除进餐的缓冲作用。
结果
与空腹服用时胃pH < 4.0的中位时间百分比为42.0（四分位间距31.4 - 48.8）相比，早餐时服用药物时该值为17.2（四分位间距4.6 - 45.5）（P = 0.01）。15名受试者在早餐时服用药物时对胃酸度的控制更好。pH阈值为3时和pH中位数显示出类似差异。去除早餐期后，差异不再具有统计学意义。
结论
当需要使用奥美拉唑或兰索拉唑进行治疗时，应在餐前服药以实现对白天胃酸度的最佳控制。
Zotero 插件