胃潰瘍に対するH₂ blockerと防御因子増強剤による併用維持療法の臨床効果に関する検討

Abstract

Comparative study of combination of H₂ blocker and cytoprotective agents and H₂ blocker alone in maintenance therapy was performed to evaluate its efficacy in the prevention of the recurrence of gastric ulcer. For the purpose, 136 patients with endoscopically confirmed gastric or gastroduodenal ulcer were treated with one year maintenance by these drugs after healing. In the maintenance therapy, patients were divided into two groups : Group H (patients who were administered one of the H₂ blockers alone ; cimetidine 400 mg, ranitidine 150 mg or famotidine 20 mg nocte) and Group HC (patients being treated with one of the H₂ blockers and one of the cytoprotective agents ; sucralfate 1 g, teprenone 50 mg or aldioxa 100 mg 3 times a day in a combination regimen). During the maintenance therapy, the lesions were observed every 3 months by endoscopy to check for recurrence and for the stage of ulcer scar for one year. 1) Cumulative recurrence-free rate of Group HC was about 10% higher than that of Group H during 12 months of maintenance therapy. 2) In gastroduodenal ulcer patients, recurrence-free rate of Group HC was significantly higher than that of Group H (p＜0.01). 3) In patients who had recurrent ulcer and who had ulcer that was healed within 3 months after treatment, the recurrence-free rate of Group HC tended to be higher than that of Group H. 4) In these two groups, the recurrence-free rate of white ulcer scar was significantly higher than that of red ulcer scar (p＜0.05). It is concluded that the maintenance therapy of combination regimen is more effective than that of H₂ blocker alone and red ulcer scar is more likely to recur than white ulcer scar in spite of the combination maintenance therapy. This fact suggests that maintenance therapy should be continued carefully until white ulcer scar is confirmed.