质子泵抑制剂治疗NSAID所致溃疡用药方式的临床探讨

目的探讨质子泵抑制剂(PPI)不同给药方式、不同剂量以及不同疗程对非甾体类抗炎药(NSAID)所致消化性溃疡的治疗作用。方法选取住院确诊因服用NSAID导致上消化道出血的180例患者,按照疗程以及给药方式不同分为6组:A组服用奥美拉唑20mg/d,连续服用2周;B组服用奥美拉唑40mg/d,单次服用,连续服用2周;C组服用奥美拉唑40mg/d,分两次服用,连续服用2周;D组服用奥美拉唑20mg/d,连续服用4周;E组服用奥美拉唑40mg/d,单次服用,连续服用4周;F组服用奥美拉唑40mg/d,分两次服用,连续服用4周。比较不同治疗模式患者的溃疡愈合率、总有效率、腹痛缓解时间,以及3、12个月内上消化道出血的发生率。结果疗程为4周的样本人群溃疡痊愈率为66.67%,总有效率为85.56%,而疗程为2周的样本人群溃疡痊愈率为47.78%,总有效率为72.22%,两组比较差异有显著性(P<0.05)。疗程为4周的样本人群,采用40mg/d,分两次服用治疗模式,溃疡痊愈率为83.33%,总有效率为100%。结论PPI干预疗法,疗程4周的治疗模式较疗程为2周的治疗模式能够明显减少NSAID导致上消化道出血的近期发生率,提高溃疡的愈合质量。且40mg/d,分两次服用的治疗模式较20mg/d以及40mg/d单次服用的治疗模式,具有更好的疗效。

Clinical evaluation of regimens of proton pump inhibitor for peptic ulcer induced by non-steroidal anti-inflammatory drugs

Objective To evaluate the effects of proton pump inhibitor(PPI) on peptic ulcer induced by non-steroidal anti-inflammatory drugs(NSAID),by comparing of efficacy among regimens of proton pump inhibitor with different administration,different dosage and different courses of treatment.Methods 180 patients with hemorrhage in upper gastrointestinal tract induced by NSAID were divided into 6 groups according to different regimens as following: group A were treated with oral omeprazole 20 mg,once daily,for 2 weeks;group B with oral omeprazole 40 mg,once daily,for 2 weeks;group C with oral omeprazole 40 mg, twice daily,for 2 weeks;group D with oral omeprazole 20 mg,once daily,for 4 weeks;group E with oral omeprazole 40 mg,once daily,for 4 weeks;group F with oral omeprazole 40 mg,twice daily,for 4 weeks.The ulcer healing rate,total response rate and the time of abdominal pain relief,the incidence of hemorrhage in upper gastrointestinal tract within 3 months and 12 months were compared among the groups.Results The ulcer healing rate and total response rate of the patients with 4-week course of treatment were 66.67% and 85.56%,which are significantly better than that of patients with 2 weeks,47.78% and 72.22%,there was statistically different(P<0.05).The ulcer healing rate and total response rate of the patients with omeprazole 40 mg,twice daily,for 4 weeks are 83.33% and 100%.Conclusion The therapy strategy of 4-week treatment course of PPI can significantly increase the ulcer healing rate and decrease the incidence of haemorrhage in upper gastrointestinal induced by NSAID in 3 months.The regimen of oral omeprazole(40 mg,bid q12h),for 4 weeks is superior to 20mg and 40mg once daily.