Maxton D G, Heald J, Whorwell P J, Haboubi N Y
Department of Medicine, University Hospital of South Manchester.
Gut. 1990 Mar;31(3):351-4. doi: 10.1136/gut.31.3.351.
Eighty patients with reflux oesophagitis were randomised to receive either Pyrogastrone five tablets daily or cimetidine 400 mg twice daily for six weeks, extended to 12 if necessary. At six weeks, 49% of the Pyrogastrone treated subjects and 37% of the cimetidine treated subjects were healed. After 12 weeks the cumulative healing rates were 64% for Pyrogastrone and 66% for cimetidine. Compared with baseline both drugs achieved similarly significant improvements in symptom score, endoscopic and histological grading even in those who did not heal completely. Response was not related to length of symptoms or initial severity of oesophagitis. Eleven of 25 (44%) patients healed with Pyrogastrone relapsed within one year compared with 15 of 27 (56%) healed with cimetidine. Although this trend in favour of Pyrogastrone was not significant at one year the early relapse rate was significantly greater in cimetidine treated subjects. At six weeks, five cimetidine treated subjects had relapsed compared with none in the Pyrogastrone group (p = 0.05). This study shows that Pyrogastrone and cimetidine are equally effective in the healing of oesophagitis and raises the possibility that Pyrogastrone has marginal benefits in terms of time to relapse.
80例反流性食管炎患者被随机分为两组，一组每日服用5片胃复安，另一组每日服用西咪替丁400毫克，分两次服用，疗程为6周，必要时可延长至12周。6周时，服用胃复安的受试者中有49%治愈，服用西咪替丁的受试者中有37%治愈。12周后，胃复安的累积治愈率为64%，西咪替丁为66%。与基线相比，两种药物在症状评分、内镜和组织学分级方面均取得了类似的显著改善，即使是那些未完全治愈的患者。疗效与症状持续时间或食管炎的初始严重程度无关。服用胃复安治愈的25例患者中有11例（44%）在一年内复发，而服用西咪替丁治愈的27例患者中有15例（56%）复发。虽然这种有利于胃复安的趋势在一年时并不显著，但西咪替丁治疗组的早期复发率明显更高。6周时，服用西咪替丁的受试者中有5例复发，而胃复安组无一例复发（p = 0.05）。这项研究表明，胃复安和西咪替丁在食管炎愈合方面同样有效，并增加了胃复安在复发时间方面具有边际益处的可能性。
