Haq S A, Rahman M T, Hasan M, Khan A K
Dept. of Gastroenterology, Institute of Postgraduate Medicine and Research, Dhaka, Bangladesh.
Bangladesh Med Res Counc Bull. 1994 Aug;20(2):52-9.
Forty three subjects with DU confirmed at endoscopy and healed after eight weeks of sucralfate therapy were subjected to a randomized double-blind controlled trial for six months. Twenty one subjects received sucralfate (1 g one hour before breakfast and dinner). Twenty two subjects received placebo. Symptoms were evaluated every month. The subjects were endoscoped at the end of the trial or earlier in case symptoms recurred. Sucralfate was found to be significantly more effective than placebo (6/21 vs. 17/22, p < 0.005) in preventing DU relapse. Age at presentation, age at onset, duration of illness, sex, periodicity, smoking, gastric stasis like symptoms, associated irritable bowel syndrome, degree of deformity of the bulb and initial presence of duodenitis were the factors examined for their effect upon the relapse. In the placebo group relapsers had significantly shorter mean duration of illness indicating that DU may relapse more frequently in earlier part of its natural course. Other factors did not influence the relapse rate. In the sucralfate group, higher ages at onset and at presentation were associated with significantly higher relapse rate. Sucralfate may be less effective in preventing relapse in elderly and late onset DU patients.
43例经内镜检查确诊为十二指肠溃疡（DU）且在接受8周硫糖铝治疗后溃疡愈合的患者，接受了为期6个月的随机双盲对照试验。21例患者接受硫糖铝治疗（早餐和晚餐前1小时各服用1g）。22例患者接受安慰剂治疗。每月对症状进行评估。试验结束时或症状复发时提前进行内镜检查。结果发现，在预防DU复发方面，硫糖铝比安慰剂显著更有效（6/21 vs. 17/22，p<0.005）。对就诊年龄、发病年龄、病程、性别、发作周期、吸烟情况、胃潴留样症状、是否合并肠易激综合征、球部畸形程度以及初始十二指肠炎症情况等因素对复发的影响进行了研究。在安慰剂组中，复发患者的平均病程显著较短，这表明DU在其自然病程的早期可能更频繁地复发。其他因素未影响复发率。在硫糖铝组中，发病年龄和就诊年龄较大与复发率显著较高相关。硫糖铝在预防老年和晚发性DU患者复发方面可能效果较差。
