Cohen S, Booth G H
N Engl J Med. 1975 Oct 30;293(18):897-9. doi: 10.1056/NEJM197510302931803.
Caffeine stimulates gastric acid secretion and reduces the competence of the lower esophageal sphincter in man. These effects of caffeine have been used as evidence that regular coffee should not be used by patients with peptic-ulcer disease or gastroesophageal reflux. We compared the dose-response relations of caffeine, regular coffee and decaffeinated coffee for gastric acid secretion and sphincter pressure in normal subjects. Decaffeinated coffee gave a maximal acid response of 16.5 +/- 2.6 mEq per hour (mean +/- S.E.M.), which was similar to that of regular coffee, 20.9 +/- 3.6 mEq per hour, both values being higher than that of caffeine, 8.4 +/- 1.3, on a cup-equivalent basis. Sphincter pressure showed minimal changes in response to caffeine, but was significantly increased by both regular and decaffeinated coffee (P less than 0.05). These data suggest that clinical recommendations based upon the known gastrointestinal effects of caffeine may bear little relation to the actual observed actions of coffee or decaffeinated coffee.
咖啡因可刺激人体胃酸分泌，并降低食管下括约肌的功能。咖啡因的这些作用被用作证据，表明消化性溃疡病或胃食管反流患者不应饮用常规咖啡。我们比较了咖啡因、常规咖啡和脱咖啡因咖啡对正常受试者胃酸分泌和括约肌压力的剂量反应关系。脱咖啡因咖啡每小时的最大酸反应为16.5±2.6毫当量（平均值±标准误），与常规咖啡每小时20.9±3.6毫当量的酸反应相似，以杯等量为基础，这两个值均高于咖啡因的8.4±1.3。括约肌压力对咖啡因的反应变化极小，但常规咖啡和脱咖啡因咖啡均可使其显著升高（P<0.05）。这些数据表明，基于咖啡因已知的胃肠道作用所给出的临床建议，可能与实际观察到的咖啡或脱咖啡因咖啡的作用关系不大。
