Mohammed R, Holden R J, Hearns J B, McKibben B M, Buchanan K D, Crean G P
Gut. 1983 Jan;24(1):61-6. doi: 10.1136/gut.24.1.61.
Gastric acid secretion, pepsin secretion, and fasting serum gastrin levels were measured in 23 patients with duodenal ulcer disease, divided into three groups which received either cimetidine 800 mg daily, cimetidine 1600 mg daily, or ranitidine hydrochloride 300 mg daily for eight weeks. Pentagastrin tests were carried out at intervals both before and after treatment. Each dose of cimetidine reduced acid secretion to 42% of control one week after starting therapy. Ranitidine reduced acid secretion to 33% of the pretreatment value. Acid secretion remained suppressed to these levels throughout treatment with each drug. Acid secretion returned to pretreatment levels in all patients one week after treatment and remained normal until the end of the study. Both drugs reduced pepsin, which fell to 64% and 61% (p less than 0.01) after 800 mg and 1600 mg cimetidine respectively and to 65% (p less than 0.005) with ranitidine after one week's treatment. Pepsin secretion remained at this reduced level in both cimetidine groups till the end of treatment. Pepsin levels fell to 50% at two weeks of therapy with ranitidine but stabilised at this level till the end of therapy. Cimetidine withdrawal was followed by a return towards pretreatment levels of pepsin secretion; but secretion remained significantly depressed (p less than 0.05) to the end of the study period. In the ranitidine-treated patients pepsin output returned to normal after drug withdrawal. Fasting gastrin levels rose during treatment with both drugs but failed to reach significant levels. After withdrawal of treatment fasting serum gastrin levels returned to normal in all three groups of patients.
对23例十二指肠溃疡病患者测定了胃酸分泌、胃蛋白酶分泌及空腹血清胃泌素水平。这些患者被分为三组，分别接受每日800毫克西咪替丁、每日1600毫克西咪替丁或每日300毫克盐酸雷尼替丁治疗，为期8周。在治疗前后定期进行五肽胃泌素试验。开始治疗一周后，各剂量的西咪替丁均将胃酸分泌降低至对照值的42%。雷尼替丁将胃酸分泌降低至治疗前值的33%。在整个治疗过程中，每种药物均使胃酸分泌维持在这些水平。治疗一周后，所有患者的胃酸分泌均恢复至治疗前水平，并一直保持正常直至研究结束。两种药物均降低了胃蛋白酶水平，服用800毫克和1600毫克西咪替丁一周后，胃蛋白酶水平分别降至64%和61%（p<0.01），服用雷尼替丁一周后降至65%（p<0.005）。在西咪替丁治疗的两组中，胃蛋白酶分泌在整个治疗期间均维持在降低后的水平。雷尼替丁治疗两周时胃蛋白酶水平降至50%，但在治疗结束前一直稳定在该水平。停用西咪替丁后，胃蛋白酶分泌水平恢复至治疗前水平；但在研究期结束时，分泌水平仍显著降低（p<0.05）。在雷尼替丁治疗的患者中，停药后胃蛋白酶分泌恢复正常。两种药物治疗期间空腹胃泌素水平均升高，但未达到显著水平。停药后，所有三组患者的空腹血清胃泌素水平均恢复正常。
