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西咪替丁——治疗消化性溃疡的新原理(作者译)

[Cimetidine--a new principle in treating peptic lesions (author's transl)].

作者信息

Arendt R

出版信息

Zentralbl Chir. 1979;104(17):1089-94.

PMID:395796
Abstract

A survey is given on the present state of experience with Cimetidine. Cimetidine significantly promotes healing of duodenal and gastric ulcers; this effect is especially significant in countries with low spontaneous ulcer healing. Prophylactically administered Cimetidine is the only drug capable of decisively lowering the recurrence rate of duodenal ulcers. In certain cases, Cimetidine long-term treatment therefore seems to compete with elective gastric operations. However apart from the operative risk surgery of the stomach (especially selective gastric vagotomy) still provides certain advantages. Controlled long-term trials are still required in order to come to a clear-cut delimitation between the indications for Cimetidine prophylaxis and elective operation. Furthermore prophylaxis with Cimetidine prevents gastric bleeding from erosions in stress-patients. Even in Zollinger-Ellison-syndrome Cimetidine enables ulcers to heal and patients to reach operability. In patients with operable gastrinomas the long-term treatment with Cimetidine seems to replace palliative total gastrectomy by curative resection of the tumour.

摘要

本文综述了西咪替丁的应用现状。西咪替丁能显著促进十二指肠溃疡和胃溃疡的愈合;在溃疡自然愈合率较低的国家,这种作用尤为显著。预防性使用西咪替丁是唯一能显著降低十二指肠溃疡复发率的药物。因此,在某些情况下,西咪替丁的长期治疗似乎可替代选择性胃部手术。然而,除了手术风险外,胃部手术(尤其是选择性胃迷走神经切断术)仍具有一定优势。为明确西咪替丁预防和选择性手术的适应症,仍需进行对照长期试验。此外,西咪替丁预防可防止应激患者因糜烂导致胃出血。即使在卓-艾综合征中,西咪替丁也能使溃疡愈合,并使患者达到可手术状态。对于可手术的胃泌素瘤患者,西咪替丁的长期治疗似乎可通过肿瘤根治性切除术替代姑息性全胃切除术。

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