Johnston D A, Wormsley K G
Ninewells Hospital, Dundee, Scotland.
Scand J Gastroenterol. 1988 Nov;23(9):1137-40. doi: 10.3109/00365528809090181.
The overnight gastric secretion of patients with duodenal ulcer or oesophagitis and of healthy volunteers known to be gastric nocturnal hypersecretors was studied after administration of ranitidine at 1815 h or 2200 h. Patients with oesophagitis showed a significant therapeutic 'gain' after the earlier (1815 h) dosing, with gastric inhibition lasting an average of 5 h longer. A similar pattern was observed in the nine patients with duodenal ulcer, although three of these patients showed some degree of escape from the gastric inhibition after 0400 h following the 1815 h administration of ranitidine. All of the volunteers also had better inhibition before midnight with the earlier dosing, but after midnight the gastric inhibition was significantly less after the 1815 h than after the 2200 h dosing with ranitidine. We conclude that early evening dosing with ranitidine is the treatment of choice for patients with reflux oesophagitis. However, bedtime administration of ranitidine is preferable for individuals with gastric hypersecretion, since earlier dosing may result in failure to inhibit gastric secretion satisfactorily during most of the night.
在18:15或22:00给予雷尼替丁后,研究十二指肠溃疡或食管炎患者以及已知为夜间胃酸分泌过多的健康志愿者的夜间胃分泌情况。食管炎患者在较早(18:15)给药后显示出显著的治疗“获益”,胃抑制平均持续时间延长5小时。在9例十二指肠溃疡患者中观察到类似模式,尽管其中3例患者在18:15给予雷尼替丁后,04:00后出现了一定程度的胃抑制逃逸。所有志愿者在午夜前较早给药时也有更好的抑制效果,但午夜后,18:15给药后的胃抑制明显低于22:00给予雷尼替丁后的抑制效果。我们得出结论,对于反流性食管炎患者,傍晚早期给予雷尼替丁是首选治疗方法。然而,对于胃酸分泌过多的个体,睡前给予雷尼替丁更可取,因为较早给药可能导致在夜间大部分时间内无法令人满意地抑制胃分泌。