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目的 观察十二指肠溃疡患者夜间酸突破 (NAB)现象 ,以探讨不同治疗方案对NAB的控制效果。方法 将 2 0 0 2 - 0 6～ 2 0 0 3- 0 4大连医学院附属二院消化科 4 0例十二指肠溃疡患者随机分为 4组 ,每组 10例 ,A组 :口服奥美拉唑 2 0mg ,每日 2次 ,法莫替丁 2 0mg睡前口服 ;B组 :口服奥美拉唑 2 0mg ,每日 2次 ;C组 :口服奥美拉唑 2 0mg ,每日 1次 ,法莫替丁 2 0mg睡前口服 ;D组 :口服奥美拉唑 2 0mg ,每日 1次。用药 5d ,于第 5天监测 2 4h胃内pH值。结果 (1)A组患者没有NAB发生 ,B、C组均分别只有 1例发生 ,D组发生 6例。A、B、C 3组显著低于D组 (P <0 0 5 )。 (2 ) 4组患者的平均胃内 pH值、平均中位pH、夜间平均胃内 pH、和夜间平均中位 pH比较 ,A组显著高于其他各组 (P <0 0 5 ) ;而B组与C组明显高于D组 (P <0 0 5 ) ,B、C组之间差异无显著性 ;D组各项指标均低于其他各组 (P <0 0 5 )。 (3)A组 pH <4 0的时间占总检测时间的百分比、夜间 pH <4 0的时间占夜间检测时间的百分比均显著低于其它各组 (P <0 0 1) ,而B组与C组均明显低于D组 (P <0 0 5 ) ,B、C组之间相比差异无显著性 ;D组明显高于其它各组 (P <0 0 5 )。结论 十二指肠溃疡患者治疗过程中单用奥美拉唑多发生NAB ,改变奥美拉唑用
Objective To observe the nocturnal acid breakthrough (NAB) in patients with duodenal ulcer to explore the effect of different treatment regimens on NAB control. Methods A total of 40 patients with duodenal ulcer in digestive department of Second Affiliated Hospital of Dalian Medical College were randomly divided into 4 groups with 10 cases in each group. Group A: Group B: oral omeprazole 20mg, 2 times a day; Group C: oral omeprazole 20mg, daily 1 times, famotidine 20mg before going to bed; Group D: oral omeprazole 20mg, 1 day. On the 5th day, the intragastric pH value was monitored for 24 hours after treatment for 5 days. Results (1) There was no NAB in group A, only 1 in group B and 6 in group D, and 6 in group D. A, B, C 3 group was significantly lower than D group (P <0 05). (2) The average intragastric pH, mean median pH, nighttime mean intragastric pH, and nighttime mean median pH in group A were significantly higher than those in other groups (P <0.05); while group B Group C and C were significantly higher than those in Group D (P <0.05). There was no significant difference between Group B and C (P <0.05). All indexes in Group D were lower than those in other groups (P <0.05). (3) The percentage of time of pH <40 in group A was lower than that in other groups (P <0.01), the percentage of nighttime pH <40 was significantly lower than that of other groups (P <0.01) C group were significantly lower than the D group (P <0 05), B, C group, the difference was not significant; D group was significantly higher than the other groups (P <0 05). Conclusion Duodenal ulcer patients treated with omeprazole more than NAB, change omeprazole