[Comparison of acid and Helicobacter pylori in ulcerogenesis of duodenal ulcer disease].

To test the efficacy of short-term ranitidine and antibacterial drugs in patients with H. Pylori associated duodenal ulcer disease and to compare the importance of acid and H. Pylori in ulcerogenesis, 90 outpatients were randomly assigned to one of five regimens: ranitidine, 150 mg in the morning and at bedtime; gentamicin, 40 mg tid; terramycin, 500 mg tid; furazolidone, 100 mg tid; or berberine, 300 mg tid. The patients were evaluated endoscopically, microbiologically and histologically before and 6 weeks after oral administration of the drugs. There were no significant differences among the 5 groups with regard to age, sex, duration of disease, nonsmokers and ulcer size. The efficacy of ranitidine and antibacterial drugs was as follows: ulcer healing: ranitidine 97%; antibacterial drugs 53%-67%; H. Pylori clearance, ranitidine 3%, antibacterial drugs 40%-60%; improvement of accompanying antral gastritis, ranitidine 7%, antibacterial drugs 67%-73%; disappearance of active antral gastritis, ranitidine 7%, antibacterial drugs 50%-71%. We conclude that the healing of duodenal ulcer is not influenced by the presence of H. Pylori, and does not appear to be associated with improvement of accompanying antral gastritis and disappearance of active antral gastritis. These findings suggest that acid secretion is more important than H. Pylori in ulcerogenesis.