Grossman M I, Guth P H, Isenberg J I, Passaro E P, Roth B E, Sturdevant R A, Walsh J H
Ann Intern Med. 1976 Jan;84(1):57-67. doi: 10.7326/0003-4819-84-1-57.
There have been notable advances in knowledge about peptic ulcer recently. Gastrin-producing tumors have been recognized as a rare cause of ulcer, and multiple physiologic defects have been found in duodenal ulcer, including excessive release of gastrin after food intake, increased sensitivity to gastrin, and decreased inhibition by low pH. The tendency of gastric ulcer patients to reflux duodenal contents into the stomach may have pathogenetic significance. Two new classes of drugs strongly inhibit acid secretion in man: chemically modified prostaglandins and histamine analogues which block the action of histamine on acid secretion. Their value in treating ulcer is now being assessed in clinical trials. A new operation for duodenal ulcer shows promise: only those vagal fibers innervating the acid-secreting part of the stomach are severed, thus obviating the need for a drainage procedure and decreasing some of the undersirable side effects of earlier operations.
近年来，关于消化性溃疡的知识有了显著进展。产生胃泌素的肿瘤已被确认为溃疡的罕见病因，并且在十二指肠溃疡中发现了多种生理缺陷，包括进食后胃泌素过度释放、对胃泌素敏感性增加以及低pH值抑制作用减弱。胃溃疡患者十二指肠内容物反流至胃的倾向可能具有致病意义。两类新型药物能强烈抑制人体胃酸分泌：化学修饰的前列腺素和阻断组胺对胃酸分泌作用的组胺类似物。它们在治疗溃疡方面的价值目前正在临床试验中进行评估。一种治疗十二指肠溃疡的新手术显示出前景：仅切断支配胃泌酸部位的迷走神经纤维，从而无需进行引流手术，并减少了早期手术的一些不良副作用。
