Jones R H, Baxter G
Department of General Practice, UMDS (Guy's and St Thomas's), London, UK.
Aliment Pharmacol Ther. 1997 Jun;11(3):541-6. doi: 10.1046/j.1365-2036.1997.00179.x.
To compare lansoprazole 30 mg daily with ranitidine 150 mg b.d. in the treatment of acid-related dyspepsia in general practice.
In a double-blind, parallel group, randomized, mutlicentre study conducted in 32 general practices in the UK, 213 patients were randomized to receive lansoprazole 30 mg daily, and 219 to receive ranitidine 150 mg b.d., for 4 weeks. All patients had experienced symptoms of reflux-like or ulcer-like dyspepsia on at least 4 of the 7 days prior to the study; 75% had experienced dyspepsia in the past, and 74 of the lansoprazole patients and 77 of the ranitidine patients had documented histories of acid-related disorders, investigating by either radiology or endoscopy.
After 2 weeks 55% of the lansoprazole patients and 33% of the ranitidine group were symptom-free (P = 0.001, chi 2 = 7.12) with corresponding 4-week figures of 69% and 44%, respectively (P = 0.001, chi 2 = 18.03). Similar figures were found at both 2 and 4 weeks for daytime and night-time heartburn and epigastric pain scores; in the lansoprazole group, at 4 weeks, 80% of patients were free of daytime heartburn and 81% of night-time epigastric pain, compared with 55% (P = 0.001, chi 2 = 15.44) and 65% (P = 0.01, chi 2 = 6.10) in the ranitidine group.
Superior symptom relief for patients presenting with ulcer-like and reflux-like symptoms in general practice is provided by lansoprazole 30 mg daily compared with ranitidine 150 mg twice daily.
在全科医疗中比较每日服用30毫克兰索拉唑与每日两次服用150毫克雷尼替丁治疗酸相关性消化不良的效果。
在英国32家全科诊所进行的一项双盲、平行组、随机、多中心研究中,213例患者被随机分配接受每日30毫克兰索拉唑治疗,219例患者接受每日两次150毫克雷尼替丁治疗,为期4周。所有患者在研究前7天中至少有4天出现反流样或溃疡样消化不良症状;75%的患者过去曾有消化不良症状,兰索拉唑组74例患者和雷尼替丁组77例患者有通过放射学或内镜检查记录的酸相关性疾病病史。
2周后,兰索拉唑组55%的患者症状消失,雷尼替丁组为33%(P = 0.001,卡方 = 7.12),4周时相应数据分别为69%和44%(P = 0.001,卡方 = 18.03)。在2周和4周时,白天和夜间烧心及上腹痛评分的情况相似;在兰索拉唑组,4周时,80%的患者白天无烧心症状,81%的患者夜间无上腹痛症状,而雷尼替丁组分别为55%(P = 0.001,卡方 = 15.44)和65%(P = 0.01,卡方 = 6.10)。
在全科医疗中,对于出现溃疡样和反流样症状的患者,每日服用30毫克兰索拉唑比每日两次服用150毫克雷尼替丁能更有效地缓解症状。