Loizeau E
Schweiz Med Wochenschr. 1986 Oct 4;116(40):1371-4.
H2-receptor antagonists, sucralfate, pirenzepine and antacids are effective, when given prophylactically, in preventing relapse of peptic ulcer. H2-receptor antagonists and sucralfate are the most widely used and are virtually free of side effects. Cessation of smoking, a balanced diet and a calm life-style are also part of the prophylaxis. The incidence of relapse is reduced by 50-80% over a period of 1-2 years. The economic and clinical benefits of prophylaxis are shown. It is indicated in cases of chronic, relapsing ulcers; complicated ulcers; in medically compromised subjects and in those with heavy responsibilities. Prophylaxis is unduly costly when given after a first episode of peptic ulcer or when episodes are infrequent. For patients with one or two episodes a year the decision to give prophylaxis depends on the patient's wishes. Prophylaxis of stress-induced haemorrhagic lesions depends on the securing of an intragastric pH greater than 3.5-5, usually achieved by hourly administration of antacids. Methylated prostaglandins and H2-receptor antagonists can prevent drug induced peptic lesions. Under the protection of one of these drugs it is possible to continue antiinflammatory treatment at the lowest possible dose.
H2受体拮抗剂、硫糖铝、哌仑西平和抗酸剂在预防性使用时，对预防消化性溃疡复发有效。H2受体拮抗剂和硫糖铝使用最为广泛，且几乎没有副作用。戒烟、均衡饮食和平和的生活方式也是预防措施的一部分。在1至2年的时间里，复发率可降低50%至80%。已显示出预防的经济和临床效益。它适用于慢性复发性溃疡、复杂性溃疡、身体状况不佳的患者以及责任重大的患者。在消化性溃疡首次发作后或发作不频繁时进行预防成本过高。对于每年发作一两次的患者，是否进行预防取决于患者的意愿。对应激性出血性病变的预防取决于将胃内pH值维持在大于3.5至5，这通常通过每小时服用抗酸剂来实现。甲基化前列腺素和H2受体拮抗剂可预防药物性消化性病变。在这些药物之一的保护下，可以以尽可能低的剂量继续进行抗炎治疗。
