Corinaldesi R, Paternicó A, Stanghellini V, Di Febo G, Biasco G, Caló G, Monetti N, Tosetti C, Barbara L
First Medical Clinic, University of Bologna, Italy.
J Clin Gastroenterol. 1991 Jun;13(3):296-302. doi: 10.1097/00004836-199106000-00009.
Gastric acid secretion, gastric emptying of solids, and the effects of short-term treatment with 300 mg ranitidine at bedtime were evaluated in symptomatic patients with endoscopically and histologically proven duodenitis. The patients investigated had basal and pentagastrin-stimulated gastric acid hypersecretion, but normal gastric emptying times. Ranitidine brought about a significant improvement of endoscopic and histological features compared with the pretreatment findings. Endoscopic but not histological improvement was significantly better than with placebo. Furthermore, ranitidine brought about a significant reduction of weekly antacid consumption compared with placebo. Both ranitidine and placebo induced significant symptomatic improvement over basal conditions, but the difference between the two treatments did not reach statistical significance. Gastric secretory and motor functions, as well as the response to therapy, were similar in duodenitis patients with and without previous history of duodenal ulcer; the only exception was in antacid consumption, which was higher in the placebo group in those with past evidence of ulcer disease. Our results suggest that duodenitis patients have secretory and motor functions similar to those of duodenal ulcer patients. Therefore, further trials on large populations of duodenitis patients with antisecretory drugs are justified.
对经内镜和组织学证实患有十二指肠炎的有症状患者,评估了胃酸分泌、固体食物的胃排空以及睡前服用300毫克雷尼替丁短期治疗的效果。所研究的患者基础胃酸分泌和五肽胃泌素刺激的胃酸分泌过多,但胃排空时间正常。与治疗前结果相比,雷尼替丁使内镜和组织学特征有显著改善。内镜改善显著优于安慰剂,但组织学改善并非如此。此外,与安慰剂相比,雷尼替丁使每周抗酸剂消耗量显著减少。雷尼替丁和安慰剂均使症状较基础状态有显著改善,但两种治疗之间的差异未达到统计学显著性。有十二指肠溃疡既往史和无十二指肠溃疡既往史的十二指肠炎患者,其胃分泌和运动功能以及对治疗的反应相似;唯一的例外是抗酸剂消耗量,有溃疡病既往证据的患者中,安慰剂组的消耗量更高。我们的结果表明,十二指肠炎患者的分泌和运动功能与十二指肠溃疡患者相似。因此,对大量十二指肠炎患者使用抗分泌药物进行进一步试验是合理的。