Shuman R B, Schuster D P, Zuckerman G R
Ann Intern Med. 1987 Apr;106(4):562-7. doi: 10.7326/0003-4819-106-4-562.
The combined data from 16 prospective trials (2133 patients) appear to suggest that antacids prevent stress ulcer bleeding more effectively than does cimetidine. However, the use of occult blood detection methods to diagnose stress ulcer bleeding may have led to the recognition of clinically insignificant bleeding. When the data from these trials are categorized according to the criteria used for the diagnoses of bleeding (either occult blood detection or clinically overt bleeding), there was no significant difference between antacids and cimetidine in the prevention of overt bleeding (3.3% of 458 compared with 2.7% of 402 patients who bled, respectively; p = 0.69). In addition, both agents were more effective (p less than 0.001) than placebo (15% of 720 patients who bled) in the prevention of overt bleeding. Cimetidine and antacids are equal in preventing significant stress ulcer bleeding.
16项前瞻性试验（共2133例患者）的综合数据似乎表明，抗酸剂在预防应激性溃疡出血方面比西咪替丁更有效。然而，使用潜血检测方法诊断应激性溃疡出血可能导致识别出临床上无显著意义的出血。当根据出血诊断标准（潜血检测或临床显性出血）对这些试验的数据进行分类时，抗酸剂和西咪替丁在预防显性出血方面没有显著差异（458例中3.3%出血，402例出血患者中分别为2.7%；p = 0.69）。此外，在预防显性出血方面，这两种药物均比安慰剂（720例出血患者中的15%）更有效（p < 0.001）。西咪替丁和抗酸剂在预防严重应激性溃疡出血方面效果相当。
