Zaterka S, Massuda H, Chinzon D, Eisig J N, Miszputen S, Kendo M, Silva A E, Ferrari Júnior A P, Castro L P, Castro F J
Department of Clinical Gastroenterology, Hospital das Clínicas da F.M.U.S.P., Brazil.
Am J Gastroenterol. 1993 Mar;88(3):397-401.
Two hundred and forty-one patients with at least one ulcer at stage A1 or A2, measuring at least 5 mm in its larger diameter, were included in this Brazilian double-blind randomized study. Patients received omeprazole 20 mg in the morning (n = 120) or ranitidine 300 mg at night (n = 121) for 2 wk; unhealed ulcers were treated for an additional 2 wk. At the end of 4 wk, unhealed ulcers were treated openly with omeprazole 20 mg o.m. for 4 wk. Healing rates at 2 and 4 wk were 67.3% and 92.9% for omeprazole and 39.8% and 82.0% for ranitidine (per protocol analysis). Results were similar when analyzed as intention to treat (p significant in favor of omeprazole). Epigastric day-time pain was the most common of all symptoms (89.2%), but only heartburn at day 15 showed a significantly better response to omeprazole than to ranitidine. A multivariate analysis (logit analysis) showed that the odds in favor of healing were greater for small ulcers, nonsmokers, and omeprazole treatment.
241例患有至少一处A1或A2期溃疡、最大直径至少5毫米的患者被纳入这项巴西双盲随机研究。患者分别在早晨服用20毫克奥美拉唑(n = 120)或在晚上服用300毫克雷尼替丁(n = 121),持续2周;未愈合的溃疡再治疗2周。在4周结束时,未愈合的溃疡采用20毫克奥美拉唑口服进行开放治疗,持续4周。按照方案分析,奥美拉唑组在2周和4周时的愈合率分别为67.3%和92.9%,雷尼替丁组分别为39.8%和82.0%。在意向性分析时结果相似(p值显著有利于奥美拉唑)。上腹部日间疼痛是所有症状中最常见的(89.2%),但仅在第15天时,奥美拉唑对烧心症状的缓解显著优于雷尼替丁。多因素分析(logit分析)显示,小溃疡、不吸烟者和接受奥美拉唑治疗的患者愈合几率更大。