Ruszniewski P, Slama A, Pappo M, Mignon M
Department of Gastroenterology, Hôpital Beaujon, Clichy, France.
Gut. 1993 Dec;34(12):1662-5. doi: 10.1136/gut.34.12.1662.
Maintenance treatment of duodenal ulcer (DU) with ranitidine 150 mg/day was compared with placebo in a two year prospective multicentre randomised study. Three hundred and ninety nine patients were included (mean age: 44.7 years, M/F ratio = 2.47/1; 37.6% of smokers) in placebo (n = 202) and ranitidine (n = 197) groups. Efficacy was assessed by the length of time to the first ulcer pain attack (with or without endoscopic confirmation) or DU complication. One hundred and fourteen patients of 399 (28.6%) had incomplete follow up. Actuarial survival curves of patients without ulcer pain (26 and 53% at two years in placebo and ranitidine groups, respectively) were significantly different (p < 0.0001). Endoscopies were performed depending on physicians' decision (mainly where there was severe pain or complication). Patients without relapses from endoscopy were more frequent in the ranitidine group (83%) than in the placebo group (47%, p < 0.0001). A greater incidence of complications, mainly bleeding, was also seen in the placebo group (13 complications v two in the ranitidine group, p < 0.002). No factor predicting DU relapse was identified. No important side effect was encountered. Ranitidine 150 mg/day is effective and well tolerated in preventing ulcer pain attacks and DU complications for up to two years.
在一项为期两年的前瞻性多中心随机研究中,对雷尼替丁150毫克/天维持治疗十二指肠溃疡(DU)与安慰剂进行了比较。安慰剂组(n = 202)和雷尼替丁组(n = 197)纳入了399例患者(平均年龄:44.7岁,男/女比例 = 2.47/1;吸烟者占37.6%)。通过首次溃疡疼痛发作(无论有无内镜证实)或DU并发症的时间长度来评估疗效。399例患者中有114例(28.6%)随访不完全。无溃疡疼痛患者的精算生存曲线(安慰剂组和雷尼替丁组两年时分别为26%和53%)有显著差异(p < 0.0001)。根据医生的决定进行内镜检查(主要是在有严重疼痛或并发症的情况下)。雷尼替丁组内镜检查无复发的患者比安慰剂组更常见(83%对47%,p < 0.0001)。安慰剂组并发症发生率更高,主要是出血(13例并发症对雷尼替丁组2例,p < 0.002)。未发现预测DU复发的因素。未遇到重要的副作用。雷尼替丁150毫克/天在预防溃疡疼痛发作和DU并发症方面长达两年有效且耐受性良好。