Bumm R, Blum A L, Bauerfeind P, Emde C
Division of Gastroenterology, CHUV, Lausanne, Switzerland.
Aliment Pharmacol Ther. 1987;1 Suppl 1:518S-526S. doi: 10.1111/j.1365-2036.1987.tb00661.x.
Intragastric pH monitoring has shown that the distribution of acidity within the stomach is not homogeneous. Not only is it affected by meals but it also has a circadian rhythm in which nocturnal pH falls to very acid levels in normal subjects. Although results of pH monitoring are highly reproducible within individuals, considerable inter-individual variation has been shown. Duodenal ulcer patients do not appear to possess the normal buffering reaction to meals, but their night-time acidity is within the normal range. In these patients, antacids and pirenzepine have a small acid-neutralizing effect in the stomach; cimetidine is less potent than ranitidine and famotidine. Clinicians can choose between a single dose of either ranitidine or famotidine in the evening with dinner and a twice-daily regimen.
胃内pH监测表明，胃内酸度分布并不均匀。它不仅受饮食影响，还具有昼夜节律，正常受试者夜间pH值会降至非常酸性的水平。尽管pH监测结果在个体内部具有高度可重复性，但已显示出个体间存在相当大的差异。十二指肠溃疡患者似乎对饮食不具有正常的缓冲反应，但其夜间酸度在正常范围内。在这些患者中，抗酸剂和哌仑西平在胃内具有较小的酸中和作用；西咪替丁的效力低于雷尼替丁和法莫替丁。临床医生可以选择在晚餐时晚上单次服用雷尼替丁或法莫替丁，或者选择每日两次的用药方案。
