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静脉注射人表皮生长因子治疗胃溃疡:一项双盲对照临床研究。

Gastric ulcer treatment with intravenous human epidermal growth factor: a double-blind controlled clinical study.

作者信息

Itoh M, Matsuo Y

机构信息

First Department of Internal Medicine, Nagoya City University Medical School, Japan.

出版信息

J Gastroenterol Hepatol. 1994;9 Suppl 1:S78-83. doi: 10.1111/j.1440-1746.1994.tb01307.x.

Abstract

We introduced a double-blind controlled clinical study to compare intravenous human epidermal growth factor (hEGF) to cetraxate hydrochloride (CH), an antiulcer drug, for their healing effect on gastric ulcers. We also prospected an oral use of EGF on the basis of our experimental evidence. In the clinical trial, the rate of ulcer healing within 8 weeks was 77.9% (67/86) in patients receiving 6 micrograms EGF intravenously twice a week, being significantly greater than 51.7% (45/87) in those given CH. Taking together all aspects assessed including the healing rate, pain relief, blood examination and adverse reactions, we judged the hEGF to be a useful and safe anticuler drug. In rats, 50 micrograms/kg mouse EGF (mEGF) and 2% hydroxypropyl cellulose (HPC) or 1.0 g/kg sucralfate given by gastric intubation significantly raised the residual mEGF levels in both gastric luminal content (HPC: x 30; sucralfate: x 300 as high as those in EGF alone) and tissue (HPC: x 60; sucralfate: x 100). In addition, the combined treatments significantly promoted healing of rat gastric ulcers whereas each agent alone had no significant effect as compared with control (saline). This indicated the beneficial effect on ulcers of oral administration of EGF with agents allowing it to remain at high levels in the stomach, whereas most reports suggested less effect of oral EGF on healing of gastroduodenal ulcers. Subsequent to the clinical study, evaluation of oral use of EGF may be expected as the next step in the treatment of ulcers. The experimental evidence above would possibly be a guide for such trial.

摘要

我们开展了一项双盲对照临床研究,比较静脉注射人表皮生长因子(hEGF)和抗溃疡药物盐酸西曲酸酯(CH)对胃溃疡的愈合效果。我们还根据实验证据展望了表皮生长因子的口服应用。在临床试验中,每周静脉注射两次6微克表皮生长因子的患者,8周内溃疡愈合率为77.9%(67/86),显著高于给予盐酸西曲酸酯的患者的51.7%(45/87)。综合评估愈合率、疼痛缓解、血液检查和不良反应等各个方面,我们判定人表皮生长因子是一种有效且安全的抗溃疡药物。在大鼠中,通过胃管给予50微克/千克小鼠表皮生长因子(mEGF)以及2%羟丙基纤维素(HPC)或1.0克/千克硫糖铝,显著提高了胃腔内容物(HPC:高达单独使用表皮生长因子时的30倍;硫糖铝:高达300倍)和组织(HPC:60倍;硫糖铝:100倍)中残留的小鼠表皮生长因子水平。此外,联合治疗显著促进了大鼠胃溃疡的愈合,而与对照组(生理盐水)相比,单独使用每种药物均无显著效果。这表明将表皮生长因子与能使其在胃中保持高水平的药物口服给药对溃疡具有有益作用,而大多数报告表明口服表皮生长因子对胃十二指肠溃疡愈合的作用较小。临床研究之后,预计下一步将评估表皮生长因子的口服应用在溃疡治疗中的效果。上述实验证据可能为该试验提供指导。

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