Washington N, Wilson C G, Williams D L, Robertson C
Department of Surgery, Queen's Medical Centre, Nottingham, UK.
Aliment Pharmacol Ther. 1993 Oct;7(5):553-9. doi: 10.1111/j.1365-2036.1993.tb00132.x.
It is now becoming common practice to co-administer H2-receptor antagonists and anti-reflux agents in the treatment of reflux oesophagitis. The mechanism by which anti-reflux agents achieve flotation requires a small amount of gastric acid to be present in the stomach. This study investigated whether an anti-reflux agent would remain effective after the decrease in acid secretion produced by a typical clinical dosage regimen of cimetidine (400 mg q.d.s., 7 days). Gastric distribution and residence of a meal and an anti-reflux agent were assessed in 12 normal subjects using gamma scintigraphy. The area under the gastric and fundal emptying curves demonstrated that Liquid Gaviscon (sodium alginate compound) had a significantly greater gastric residence than the meal, both during the control period and after cimetidine pretreatment, and that the majority of the Gaviscon was located in the fundus. The distribution of Gaviscon into the fundus was not affected by cimetidine pretreatment. Cimetidine pre-treatment slightly, but not significantly, increased the time for half the meal and the Gaviscon to empty from the stomach. The results suggest that the mechanism of action of Liquid Gaviscon is not compromised by concurrent H2-antagonist therapy.
目前，在反流性食管炎的治疗中联合使用H2受体拮抗剂和抗反流药物已成为常见的治疗方法。抗反流药物实现漂浮的机制需要胃内存在少量胃酸。本研究调查了在西咪替丁（400mg，每日4次，共7天）的典型临床给药方案导致胃酸分泌减少后，抗反流药物是否仍能保持有效。使用γ闪烁扫描法评估了12名正常受试者中一顿餐和一种抗反流药物在胃内的分布和停留情况。胃和胃底排空曲线下的面积表明，在对照期和西咪替丁预处理后，Liquid Gaviscon（海藻酸钠化合物）在胃内的停留时间均显著长于餐食，且大部分Gaviscon位于胃底。西咪替丁预处理不影响Gaviscon在胃底的分布。西咪替丁预处理略微但不显著地增加了餐食和Gaviscon一半从胃内排空的时间。结果表明，Liquid Gaviscon的作用机制不会因同时使用H2拮抗剂治疗而受到影响。
