Higuchi K, Watanabe T, Tominaga K, Shiba M, Nakagawa K, Uno H, Kitada K, Satoh H, Chono S, Uchida T, Fujiwara Y, Arakawa T
Department of Gastroenterology, Graduate School of Medicine, Osaka City University, Abeno-ku, Japan.
Int J Clin Pharmacol Res. 2005;25(4):187-94.
Ranitidine has been found to have anti-inflammatory action as well as antisecretory action in experimental models. However, there are no reports in human gastric ulcer. The aim of this study was to investigate the effects of ranitidine compared with those of famotidine on the quality of gastric ulcer healing. We randomly assigned 69 consecutive patients with gastric ulcers to ranitidine (n = 34) or famotidine (n = 35) for 12 weeks, with endoscopic assessment of the quality of gastric ulcer healing and histological assessment of gastric mucosa 12 weeks after treatment started. Ulcer healing rates of over 95% were very similar in the two groups. The rates of ulcer scars with a flat pattern (good-quality healing) were significantly higher in the ranitidine group than in the famotidine group (per protocol, 63.0% and 34.5%, p = 0.033). The neutrophil infiltration score in the body mucosa treated with famotidine, but not ranitidine, significantly increased after treatment. In contrast, the mononuclear cell infiltration score in the antral mucosa treated with ranitidine, but not in that treated with famotidine, had significantly decreased. In conclusion, initial therapy with ranitidine significantly improved the quality of gastric ulcer healing and the histological scores of gastric mucosa compared with famotidine.
在实验模型中,已发现雷尼替丁具有抗炎作用和抗分泌作用。然而,在人类胃溃疡方面尚无相关报道。本研究的目的是调查雷尼替丁与法莫替丁相比对胃溃疡愈合质量的影响。我们将69例连续的胃溃疡患者随机分为雷尼替丁组(n = 34)或法莫替丁组(n = 35),治疗12周,并在治疗开始12周后通过内镜评估胃溃疡愈合质量,通过组织学评估胃黏膜。两组的溃疡愈合率均超过95%,非常相似。雷尼替丁组溃疡形成扁平模式(高质量愈合)的比例显著高于法莫替丁组(根据方案,分别为63.0%和34.5%,p = 0.033)。治疗后,法莫替丁治疗的胃体黏膜中性粒细胞浸润评分显著增加,而雷尼替丁治疗的则未增加。相反,雷尼替丁治疗的胃窦黏膜单核细胞浸润评分显著降低,而法莫替丁治疗的则未降低。总之,与法莫替丁相比,雷尼替丁初始治疗显著改善了胃溃疡愈合质量和胃黏膜组织学评分。