Ries R K, Gilbert D A, Katon W
Arch Intern Med. 1984 Mar;144(3):566-9.
The role of tricyclic antidepressants (TCAs) as agents for treatment of peptic ulcer disease is of growing interest. In both placebo-controlled clinical trials and comparative studies with cimetidine, TCAs have proved effective and safe as ulcer-healing agents. The mechanism of action by which TCAs produce healing has not been fully elucidated. In vivo studies in man have generally shown that TCAs decrease gastric acid secretion. In addition to their well-known anticholinergic properties, in vitro studies have indicated potent H1- and H2-receptor blocking activities for these agents. Separate from these effects on acid output, the antipain/depression effect of TCAs may be of benefit in certain patients with ulcers. Other advantages of these agents include their long half-lives, low cost, and readily available serum monitoring. Further clinical studies with detailed physiologic and psychologic observations and serum monitoring using TCAs in patients with peptic ulcer disease are needed.
三环类抗抑郁药（TCAs）作为治疗消化性溃疡疾病的药物，其作用正日益受到关注。在安慰剂对照临床试验以及与西咪替丁的对比研究中，三环类抗抑郁药已被证明作为溃疡愈合药物是有效且安全的。三环类抗抑郁药产生愈合作用的作用机制尚未完全阐明。人体的体内研究普遍表明，三环类抗抑郁药可减少胃酸分泌。除了其众所周知的抗胆碱能特性外，体外研究表明这些药物具有强大的H1和H2受体阻断活性。除了对胃酸分泌的这些影响外，三环类抗抑郁药的止痛/抗抑郁作用可能对某些溃疡患者有益。这些药物的其他优点包括半衰期长、成本低以及血清监测易于进行。需要对消化性溃疡疾病患者使用三环类抗抑郁药进行更详细的生理和心理观察以及血清监测的进一步临床研究。
