Houben G M, Hooi J, Hameeteman W, Stockbrügger R W
Department of Gastroenterology, Academic Hospital, Maastricht, Netherlands.
Aliment Pharmacol Ther. 1995 Dec;9(6):649-54. doi: 10.1111/j.1365-2036.1995.tb00434.x.
There is considerable controversy about the degree of acid suppression that is optimal for the treatment of peptic disorders.
To compare the effects of three different regimens that are reported to strongly inhibit acid secretion.
Intragastric 24-hour pH monitoring was performed in 11 healthy subjects in a randomized, multiple, cross-over, double-blind study. Each subject received four dose regimens, each for 2 weeks, in a random order. The regimens were: 300 mg ranitidine b.d., 20 mg omeprazole o.m., 40 mg omeprazole o.m., and placebo.
The decrease in gastric acidity during the daytime and during the total 24-hour period by all three treatments was significantly greater than after placebo; a significant difference in acid inhibition was found between ranitidine and 40 mg omeprazole, but not between ranitidine and 20 mg omeprazole, nor between the two doses of omeprazole. During the night-time the decrease in gastric acidity by all three treatments was significantly greater than after placebo; no difference was seen between the two doses of omeprazole and ranitidine. For the time of pH greater than 3 we found no statistical difference between the various acid decreasing regimens. The pH remained significantly longer above 4 after ranitidine and the two doses of omeprazole compared with placebo, and also longer above 4 after 40 mg omeprazole compared with ranitidine, but not after 20 mg omeprazole compared with ranitidine, nor after the two different doses of omeprazole.
Dosing with 300 mg ranitidine b.d., 20 mg omeprazole or 40 mg omeprazole is superior in gastric acid inhibition compared with placebo, when measured using 24-hour pH monitoring.
对于治疗消化性疾病而言，何种程度的抑酸效果最佳存在诸多争议。
比较三种据报道能强效抑制胃酸分泌的不同治疗方案的效果。
在一项随机、多组、交叉、双盲研究中，对11名健康受试者进行了24小时胃内pH监测。每位受试者随机接受四种给药方案，每种方案持续2周。方案分别为：雷尼替丁300毫克，每日两次；奥美拉唑20毫克，每日一次；奥美拉唑40毫克，每日一次；以及安慰剂。
与安慰剂相比，所有三种治疗方案在白天及整个24小时期间均使胃酸度显著降低；雷尼替丁与40毫克奥美拉唑之间的抑酸效果存在显著差异，但雷尼替丁与20毫克奥美拉唑之间、两种剂量的奥美拉唑之间均无显著差异。在夜间，所有三种治疗方案使胃酸度的降低均显著大于安慰剂；两种剂量的奥美拉唑与雷尼替丁之间未见差异。对于pH大于3的时间，我们发现不同的抑酸方案之间无统计学差异。与安慰剂相比，雷尼替丁及两种剂量的奥美拉唑使pH值在4以上持续的时间显著更长，且40毫克奥美拉唑与雷尼替丁相比，pH值在4以上持续的时间也更长，但20毫克奥美拉唑与雷尼替丁相比、两种不同剂量的奥美拉唑之间则无此差异。
采用24小时pH监测时，每日两次服用300毫克雷尼替丁、每日一次服用20毫克或40毫克奥美拉唑在抑制胃酸方面优于安慰剂。
