Chen P H, Wang T H, Wang C Y, Chen C Y, Cheng T C, Tsai Y T, Siauw C P, Yang K C, Chen G H, Sung J L
Department of Internal Medicine, Taipei Medical College, Taiwan.
J Int Med Res. 1989;17 Suppl 1:25A-31A.
In 20% of patients with duodenal ulcers, treatment is ineffective. Ulcers are considered resistant when they fail to heal following 8-12 weeks of treatment with full dose duodenal ulcer therapy. The present study reviewed the records and endoscopic findings of 73 patients who were considered by their physicians to have resistant duodenal ulcers. From this population, 15 patients with documented, active duodenal ulcers were chosen to participate in this study. Each had failed treatment with cimetidine or ranitidine at recommended doses administered for from 56 days to more than 2 years. After up to 6 weeks' treatment with 20 mg famotidine given twice daily, eight patients showed endoscopic evidence of healing (S1 or S2) based on the criteria established by the Japanese Society of Digestive Endoscopy. Five others showed moderate to marked improvement H1-H3). No patient experienced side-effects during famotidine treatment. The greater antisecretory effect of famotidine may be useful in treating duodenal ulcer patients who fail to heal with cimetidine or ranitidine.
20%的十二指肠溃疡患者治疗无效。当使用全剂量十二指肠溃疡疗法治疗8 - 12周后溃疡仍未愈合时，溃疡被视为耐药。本研究回顾了73例被医生认为患有耐药性十二指肠溃疡患者的病历和内镜检查结果。从这些患者中，选择了15例有记录的活动性十二指肠溃疡患者参与本研究。每例患者使用西咪替丁或雷尼替丁推荐剂量治疗56天至2年以上均失败。在每天两次给予20毫克法莫替丁治疗长达6周后，根据日本消化内镜学会制定的标准，8例患者内镜检查显示愈合迹象（S1或S2）。另外5例患者有中度至明显改善（H1 - H3）。法莫替丁治疗期间无患者出现副作用。法莫替丁更强的抑酸作用可能有助于治疗使用西咪替丁或雷尼替丁未能愈合的十二指肠溃疡患者。
