van Rensburg C J, Louw J A, Girdwood A H, Simjee A E, Marks I N
Department of Medicine, University of Stellenbosch, South Africa.
Aliment Pharmacol Ther. 1996 Jun;10(3):381-6. doi: 10.1111/j.0953-0673.1996.00381.x.
The proton-pump inhibitor, lansoprazole, a more potent gastric acid inhibitor with a longer action than H2-receptor antagonists, should heal refractory gastric ulcers more effectively.
Lansoprazole's efficacy in healing refractory gastric ulcer(s) (i.e. after 6 weeks of treatment with H2-receptor antagonists, antacids or sucralfate at recommended dosages, and/or a relapse within 1 year of documented gastric ulcer), was compared by a two-dose regimen in a four-centre, randomized, parallel group study. One hundred and eighteen patients (59 per group) with an endoscopically confirmed gastric ulcer > or = 3 mm, received lansoprazole 30 or 60 mg daily. We assessed efficacy endoscopically at 4 and 8 weeks, and again after documented healing during a maintenance phase of lansoprazole 30 mg/day at 2 and 4 months.
Demographic and anthropometric data were comparable. Healing rates at 4 weeks were 63% (30 mg) vs. 66% (60 mg) (95% CI, -14 to 21%) and cumulatively at 8 weeks, 83% (30 mg) vs. 81% (60 mg) (95% CI, -12 to 16%). Two and 4 months after documented healing, 86% and 78% of intention-to-treat patients remained in remission.
Lansoprazole 30 or 60 mg/day appear equally effective in healing refractory gastric ulcers, while maintenance therapy of 30 mg/day effectively prevented an ulcer relapse.
质子泵抑制剂兰索拉唑是一种比H2受体拮抗剂更强效、作用时间更长的胃酸抑制剂，应该能更有效地治愈难治性胃溃疡。
在一项四中心、随机、平行组研究中，通过双剂量方案比较了兰索拉唑治愈难治性胃溃疡（即在用H2受体拮抗剂、抗酸剂或硫糖铝按推荐剂量治疗6周后，和/或有记录的胃溃疡在1年内复发）的疗效。118例经内镜确诊为胃溃疡≥3mm的患者（每组59例），每日接受30或60mg兰索拉唑治疗。我们在4周和8周时通过内镜评估疗效，并在维持期每日服用30mg兰索拉唑2个月和4个月记录愈合情况后再次评估。
人口统计学和人体测量数据具有可比性。4周时的愈合率分别为63%（30mg组）和66%（60mg组）（95%可信区间，-14至21%），8周时累计愈合率分别为83%（30mg组）和81%（60mg组）（95%可信区间，-12至16%）。在记录愈合后2个月和4个月，86%和78%的意向性治疗患者仍处于缓解状态。
每日30或60mg兰索拉唑在治愈难治性胃溃疡方面似乎同样有效，而每日30mg的维持治疗可有效预防溃疡复发。
