Brunner G
Department of Medicine, University Medical School, Hannover, Germany.
Eur J Gastroenterol Hepatol. 1996 Oct;8 Suppl 1:S9-13. doi: 10.1097/00042737-199610001-00003.
Effective treatment of acid-related disease requires an increase in intragastric pH. The two principal pharmacological methods of attaining this goal are (1) using histamine (H2)-receptor antagonists to block H2-receptors on the parietal cell and (2) using proton-pump inhibitors to stop acid production acid at its source. H2-RECEPTOR ANTAGONISTS: H2-receptor antagonists bind loosely and non-covalently to receptors on the parietal cell. They represented a great advance when they first appeared, bringing relief to many patients and improving the standard of care, with fewer operations and hospitalizations and a generally improved quality of life. However, many patients do not respond to these drugs, either because of the nature of the disease or because of resistance to the agent. PROTON-PUMP INHIBITORS: Proton-pump inhibitors represent an advance in the therapy of acid-related disease because they inhibit all acid production, no matter what the source of the stimulus, by binding covalently to the proton pump. Compared with H2-receptor antagonists, the effect of proton-pump inhibition is longer-lasting, faster-acting, and more effective, curing 99% of patients resistant to H2-receptor antagonist therapy. These properties make proton-pump inhibitors the treatment of choice for acid-related diseases.
提高胃内pH值：有效治疗酸相关性疾病需要提高胃内pH值。实现这一目标的两种主要药理学方法是：（1）使用组胺（H2）受体拮抗剂阻断壁细胞上的H2受体；（2）使用质子泵抑制剂从源头抑制胃酸分泌。H2受体拮抗剂：H2受体拮抗剂与壁细胞上的受体以非共价方式松散结合。它们首次出现时是一大进步，使许多患者症状缓解，改善了医疗水平，减少了手术和住院次数，总体生活质量得到提高。然而，许多患者对这些药物无反应，原因可能是疾病本身特性或对药物产生耐药性。质子泵抑制剂：质子泵抑制剂是酸相关性疾病治疗的一大进展，因为它们通过与质子泵共价结合，无论刺激源是什么，都能抑制所有胃酸分泌。与H2受体拮抗剂相比，质子泵抑制作用持续时间更长、起效更快且更有效，能治愈99%对H2受体拮抗剂治疗耐药的患者。这些特性使质子泵抑制剂成为酸相关性疾病的首选治疗药物。
