Ohashi T, Sakata J, Haraguchi Y, Eto T
First Department of Internal Medicine, Miyazaki Medical College, Japan.
J Clin Gastroenterol. 1995;20 Suppl 2:S83-5. doi: 10.1097/00004836-199506002-00022.
Lansoprazole is the first proton pump inhibitor developed in Japan. We studied the clinical efficacy of lansoprazole 30 mg q.d. on peptic ulcers and the subsequent relapse rates. The endoscopic healing rate of gastric ulcers (n = 86) after 8 weeks of treatment and duodenal ulcers (n = 52) after 6 weeks of treatment were 94.2 and 96.2%, respectively. The endoscopic S2-stage shift rates in gastric and duodenal ulcers were 45.5 and 65.4%, respectively. Factors affecting healing rates of gastric ulcers included colonization by Helicobacter pylori, the size and depth of the ulcers, pretreatment stage, and ulcer history, whereas those factors did not influence healing in duodenal ulcers. The clearance rates of H. pylori after lansoprazole treatment were 54.5% in patients with gastric ulcer and 66.7% in those with duodenal ulcer. The cumulative relapse rates after 1 year with standard maintenance therapy of H2-receptor antagonists (ranitidine, famotidine, and cimetidine) were 15.8% for gastric ulcer and 21.2% for duodenal ulcer. In conclusion, lansoprazole is highly effective in peptic ulcer disease and there are few relapses after treatment. Furthermore, it is suggested that lansoprazole is efficacious against H. pylori at usual clinical doses.
兰索拉唑是日本研发的首个质子泵抑制剂。我们研究了兰索拉唑30毫克每日一次治疗消化性溃疡的临床疗效及后续复发率。治疗8周后胃溃疡(n = 86)的内镜愈合率和治疗6周后十二指肠溃疡(n = 52)的内镜愈合率分别为94.2%和96.2%。胃溃疡和十二指肠溃疡的内镜S2期转变率分别为45.5%和65.4%。影响胃溃疡愈合率的因素包括幽门螺杆菌定植、溃疡大小和深度、治疗前阶段以及溃疡病史,而这些因素对十二指肠溃疡的愈合没有影响。兰索拉唑治疗后胃溃疡患者的幽门螺杆菌清除率为54.5%,十二指肠溃疡患者为66.7%。采用H2受体拮抗剂(雷尼替丁、法莫替丁和西咪替丁)标准维持治疗1年后,胃溃疡的累积复发率为15.8%,十二指肠溃疡为21.2%。总之,兰索拉唑对消化性溃疡疾病疗效显著,治疗后复发率低。此外,提示兰索拉唑在常规临床剂量下对幽门螺杆菌有效。