Salim A S
University Department of Surgery, Medical City, Baghdad, Iraq.
Pharmacology. 1993 May;46(5):281-8. doi: 10.1159/000139056.
This prospective randomized double-blind controlled study investigated whether sulphydryl-containing agents protect against the recurrence of duodenal ulceration. To this end, DL-cysteine (200 mg 4 times daily) and DL-methionine-methyl sulphonium chloride (MMSC, 500 mg 4 times daily) were administered orally. Three hundred and six consecutive smokers with previous symptomatic endoscopy-proven duodenal ulceration which had been shown endoscopically to have healed were randomized to receive for 1 year either placebo, cimetidine 400 mg at bedtime, cysteine, or MMSC. In 221 patients evaluable for efficacy, the cumulative relapse rate at 1 year was: placebo 64%, cimetidine 30%, cysteine 11% and MMSC 12%. Cimetidine was significantly effective in preventing ulcer relapse (p < 0.01), however cysteine and MMSC were more effective in this respect (p < 0.05). In the patients who relapsed, ulcer recurrence tended to occur early on placebo but to be evenly distributed over the year on active therapy. In all the study groups, the relative frequency of symptomatic to silent relapse was similar in the first and second halves of the year and was comparable among these groups. These results show that sulphydryl-containing agents significantly reduce the recurrence rate of duodenal ulceration.
这项前瞻性随机双盲对照研究调查了含巯基药物是否能预防十二指肠溃疡复发。为此，口服给予DL-半胱氨酸（每日4次，每次200毫克）和DL-蛋氨酸甲基磺酰氯（MMSC，每日4次，每次500毫克）。306名连续的有症状十二指肠溃疡患者，此前经内镜检查证实溃疡已愈合，将其随机分为四组，分别接受为期1年的安慰剂、睡前服用400毫克西咪替丁、半胱氨酸或MMSC治疗。在221例可评估疗效的患者中，1年时的累积复发率为：安慰剂组64%，西咪替丁组30%，半胱氨酸组11%，MMSC组12%。西咪替丁在预防溃疡复发方面显著有效（p<0.01），然而半胱氨酸和MMSC在这方面更有效（p<0.05）。在复发的患者中，安慰剂组溃疡复发倾向于早期发生，而积极治疗组则在一年中均匀分布。在所有研究组中，有症状复发与无症状复发的相对频率在上半年和下半年相似，且各组之间具有可比性。这些结果表明，含巯基药物可显著降低十二指肠溃疡的复发率。
