Giercksky K E
Dept. of Surgical Oncology, Det Norske Radiumhospital, University of Oslo, Norway.
Scand J Gastroenterol Suppl. 1989;163:32-5. doi: 10.3109/00365528909091172.
It is difficult to ascertain the incidence of gastrointestinal side effects associated with intake of non-steroidal anti-inflammatory drugs (NSAIDs). Serious side effects, such as bleeding, perforation, and heart failure, occur in approximately 1% of patients using NSAIDs. One-third of all patients receiving NSAIDs will have gastrointestinal complaints. Since at least 10% of patients terminate treatment with NSAIDs as a result of side effects, even reduction of those that are not life-threatening would be of great benefit. H2-receptor antagonists have proved effective in ulcer treatment, and their use as prophylaxis against the side effects of NSAIDs is being widely studied. In a recent study, 63 patients who had experienced serious upper gastrointestinal side effects were given cimetidine while continuing their NSAID therapy. All but 4 of 47 who had gastric or duodenal ulcer on first admission were healed at 8 weeks, and none of the remaining 16 with diffuse bleeding gastritis experienced further clinical episodes of bleeding or ulcer-related dyspepsia. Bijlsma has reported a double-blind multicentre study using cimetidine or placebo. When GI symptoms led to endoscopic evaluation, GI symptoms were significantly reduced after cimetidine.
很难确定与服用非甾体抗炎药（NSAIDs）相关的胃肠道副作用的发生率。严重的副作用，如出血、穿孔和心力衰竭，在使用NSAIDs的患者中约有1%会出现。所有接受NSAIDs治疗的患者中有三分之一会有胃肠道不适。由于至少10%的患者因副作用而终止NSAIDs治疗，因此即使减少那些不危及生命的副作用也将大有裨益。H2受体拮抗剂已被证明在溃疡治疗中有效，并且它们作为预防NSAIDs副作用的用途正在被广泛研究。在最近的一项研究中，63名曾经历过严重上胃肠道副作用的患者在继续使用NSAIDs治疗的同时服用了西咪替丁。首次入院时患有胃溃疡或十二指肠溃疡的47名患者中，除4名外，其余在8周时均已愈合，其余16名患有弥漫性出血性胃炎的患者均未出现进一步的出血临床发作或与溃疡相关的消化不良。Bijlsma报告了一项使用西咪替丁或安慰剂的双盲多中心研究。当胃肠道症状导致进行内镜评估时，服用西咪替丁后胃肠道症状明显减轻。
