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目的 了解夜间酸突破现象 (NAB)并寻求解决措施。方法 胃镜确诊十二指肠球部溃疡(DU)病人 4 0例 ,随机分为 5组 ,每组 8例 ,治疗方法 :A组奥美拉唑 2 0mg ,每日 1次口服 (晨起 ) ,B组奥美拉唑 2 0mg ,每日 2次口服 (晨起及下午 4时 ) ,C组奥美拉唑 4 0mg ,每日 2次静脉注射 (晨起及下午 4时 ) ,D组奥美拉唑 2 0mg ,每日 1次口服 (晨起 ) +雷尼替丁 15 0mg临睡前服 ,E组奥美拉唑 2 0mg ,每日2次口服 (晨起及下午 4时 ) +雷尼替丁 15 0mg临睡前服。所有病人于用药治疗第 5天连续 2 4h监测胃内pH值。结果 与A组 (4.8± 0 .7,4 .7± 0 .8)相比 ,后 4组病人的平均胃内pH值、夜间平均胃内pH值显著升高 ,B组为 6 .2± 0 .7,6 .4± 1.1;C组为 6 .9± 0 .7,6 .8± 0 .9;D组为 6 .0± 0 .7,5 .9± 0 .7;E组为 5 .8± 0 .5 ,6 .1± 0 .5 ,差异均有显著性 (P <0 .0 5 )。夜间 pH <4 .0的时间百分比A组 (2 8.4± 2 9.6 )较B组 (1.5± 1.9)、C组 (1.2± 1.3)、D组 (0 .1± 0 .3)、E组 (2 .9± 5 .1)明显增高 (P <0 .0 5 )。NAB发生情况A组 5例 ,较B组 1例 ,C组 0例 ,D组 2例 ,E组 0例明显增多 (P <0 .0 5 )。幽门螺杆菌 (Hp)阴性的病人NAB发生率显著高于阳性病人。结论 DU病人 ,NAB的发生与奥美拉唑的用药剂量、用
Objective To understand the nighttime acid breakthrough (NAB) and to seek solutions. Methods Forty patients with duodenal ulcer (DU) diagnosed by gastroscope were randomly divided into 5 groups with 8 cases in each group. The treatment was as follows: A group omeprazole 20 mg orally daily (morning) , Group B omeprazole 20mg orally twice daily (early onset and 4 o’clock in the afternoon), omeprazole group 40mg, intravenous injection twice daily (morning and afternoon 4), group D Omeprazole 2 0mg daily oral (morning) + ranitidine 150mg before going to sleep, E group omeprazole 20mg, 2 times a day orally (morning and afternoon 4 o’clock) + Ranitidine 15 0mg before going to bed clothes. All patients on the 5th day of treatment for 24 hours continuous monitoring of gastric pH. Results Compared with group A (4.8 ± 0.7,4.7 ± 0.8), the average intragastric pH and nighttime average intragastric pH of the latter four groups were significantly increased, while that of group B was 6.2 ± 0 .7,6 .4 ± 1.1; C group was 6 .9 ± 0 .7,6 .8 ± 0 .9; D group was 6 .0 ± 0 .7,5 .9 ± 0 .7; E group Was 5. 8 ± 0.5, 6 .1 ± 0.5, the difference was significant (P <0.05). The time percentage of group with pH <4 .0 at night was significantly lower than that of group B (1.5 ± 1.9), group C (1.2 ± 1.3), group D (0 .1 ± 0. 3), group E 2 .9 ± 5 .1) was significantly higher (P <0.05). NAB occurred in 5 cases in group A, compared with 1 case in group B, 0 case in group C, 2 cases in group D and 0 case in group E (P <0. 05). The incidence of NAB in patients with H. pylori negative was significantly higher than in patients with positive H. pylori (Hp). Conclusion DU patients, the occurrence of NAB and omeprazole dose, with