- 期刊
The Influence of Full and Low Doses of Nocturnal Cimetidine on Gastric Emptying and Acidity in Duodenal Ulcer Patients
晚間全及低劑量Cimetidine對十二指腸潰瘍病人胃排空及酸度之影響
摘要
胃酸分泌過量在十二指腸潰瘍病人扮演著重要的致病角色，單一晚間劑量之H2接受體拮抗劑曾被認為是有效的治療選擇，同時文獻更指出使用低劑量的H2接受體拮抗劑同樣達到理想的療效。此外，病人的生理因素如胃排空及胃酸度之測量結果是否受到此項治療而改變，其臨床意義尚有待證實。因而本研究收集了53例經內視鏡診斷為十二指腸潰瘍病人經隨機分配成兩組，分別接受單一晚間劑量之Cimetidine 800毫克（第一組）或400毫克（第二組），治療時間為八周。十二指腸潰瘍在第四週及第八週之治癒率分別在第一組為53.8%及73.1%及第二組為55.6%及74.0%。胃之液體排空半量時間(GET½)在兩組患者治療前後與對照組比較並無顯著變化。雖未癒合組之GET½較癒合組稍快，但此差異未達臨床意義。胃酸、血清胃蛋白酶原及胃泌素在各組治療前後及在治癒與未治癒組之間並無顯著之差異。影響潰瘍癒合之不利變數為吸煙及晚間上腹疼痛之發生。本研究顯示使用低晚間Cimetidine劑量治療十二指腸潰瘍可獲得同樣的治療效果，病人之白天胃酸、血清胃蛋白酶原及胃泌素並未因晚間使用Cimetidine抑制胃酸分泌而改變。
並列摘要
Fifty-three patients with endoscopically proven duodenal ulcers (DU) were treated with cimetidine and randomly divided into two groups to receive a single dose of 800 mg (group 1, n=26) or a low dose of 400 mg (group 2, n=27) of cimetidine nocturnally for 8 weeks. The healing rates of DU at the fourth and eighth week in group 1 (53.8% and 73.1%) and group 2 (55.6% and 74.0%) were comparable. The gastric emptying half-time (GET½) of liquid in each of these two groups before and after eight weeks treatment showed no significant changes compared with the control subjects. There was a slight decrease of the mean GET½ in the unhealed than the healed DU patients but this difference did not reach clinical significance. There were also no statistical differences in the intra gastric pH, serum pepsinogen-I and gastrin before and after the two cimetidine regimens or between the healed and unhealed DU after their treatment for eight weeks. The adverse variables which significantly affected DU healing were cigarette smoking and occurrence of nocturnal epigastric pain. In this study, we concluded that a nocturnal low dose of cimetidine was equally effective for the healing of DU. The gastric emptying, day-time acidity as measured through endoscopic gastric aspirate, serum pepsinogen-I and gastrin were not affected by nocturnal acid suppression with cimetidine.