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1、盖爽依卡倍特钠药理作用和临床应用盖爽(依卡倍特钠)的多重药理作用四大作用机理1.抑制胃蛋白酶活性2.直接覆盖,保护创面3.抑制幽门螺杆菌4.通过增加前列腺素,增加粘液分泌、碱基及胃粘膜血流依卡倍特钠联合西咪替丁对照西咪替71单药治疗胃溃疡的一项前瞻、随机、多中心研究DUETStudyualLseofcabetandCimetidinerailJournalofGastroenterologyandHepatology(2003)18,1029-1033GASTRICACIDSUPPRESSIONCo
2、mbinationtherapyofecabetsodiumandcimetidinecomparedwithcimetidinealoneforgastriculcer:ProspectiverandomizedmulticenterstudyHIROAKIMURATA/SUNAOKAWANO?SHINGOTSUJI/TAKENOBUKAMADA?YUUJIMATSUZAWA,5KENICHIKATSU;KYOUICHIINOUE/*KENICHIKOBAYASHI尹SYOUJIMITSUFUJI
3、«TADAOBAMBA«HIRONAKAKAWASAKI;1GOROUKAJIYAMA/**EIJIUMEGAKI;MASANORIINOUEWANDICHIMONJISAITO***MurataH,etal.JGastroenHepatol,2003;18:1029-1033.实验设计:多中心(47家)随机,封筒法比较试验对象患者:胃溃疡患者(A1,A2)200例评价:内镜检查(第4周、第8周)自觉症状(第2周、第4周、第8周)
4、服药疗程8周[单药组(97例)西咪替丁400mgb.i.d.双药组(
5、103例)>Forty-sevenhospitalsinJapanparticipatedinthepresentprospectiverandomizedstudy.>Patients,whoseailmenthadbeendiagnosedbyendoscopyasactivebenigngastriculcer,enrolledinthestudyafterinformedconsentwasobtained.>Patientswererandomizedbytheenvelopemethod
6、andweredividedintotworegimengroups:/theECgroup,8weeksofecabet1gb.i.dandcimetidine400mgb.i.d;/andtheCgroup,8weeksofcimetidine400mgb.i.d.>Patientswereaskedviaaquestionnaireaboutsubjectivesymptomssuchasepigastralgia,dyspepsia,andheartburnafter2,4and8weeks
7、.Symptomreliefwasdefinedasthestatuswhereallsymptomsdisappeared.>Theyunderwentendoscopicexaminationafter4and8weeksoftreatment.Ulcerhealingwasdefinedastheappearanceofanulcerscar.>At4weeks,thehealingrateswere60%(95%confideneeinterval(CI)=48-72)intheECgrou
8、pand36%(95%CI=24-48)intheCgroup,andtheECregimenwassignificantlymoreeffectivethantheCregimen(p<0.01).>Thesametrendwasalsoconfirmedafter8weeksoftreatment.ThehealingratesweresignificantlyhigherintheECgroupthanintheCgroupbytheintention-to-treatanalysis(ITT
9、)(82%vs58%,p<0.01)andperprotocolanalysis(PP)(90%vs64%zp<0.001)asshowninTable2.Table2CumulativeulcerhealingratesAnalysiswECgroup(%)Cgroup(%)P-valueITT
10、82(95%CI=74-90)58(95%CI=48-68)<0.01IPP90(95%Cl=84-96)64(95%Cl=54-74)<0.001CLconfidence