Therapeutic effects of low-doses acid-reducing agents in patients with duodenal ulcer
Lai, K.H.; Ng, W.W.; Tsai, Y.T.; Tam, T.N.; Lo, G.H.; Chang, F.Y.; Lin, H.J.; Lee, S.D.
Journal of the Formosan Medical Association 87(5): 544-548
1988
ISSN/ISBN: 0371-7682 PMID: 3418314 Document Number: 306277
Two hundred and two patients with endoscopically proven duodenal ulcers were randomized into four acid-reducing treatment groups: group I (n = 55), single nocturnal dose of 800 mg cimetidine; group II (n = 53), single nocturnal dose of 400 mg cimetidine; group III (n = 48), liquid antacid with total HCl neutralizing capacity 355.6 mmol/day; group IV (n = 46), liquid antacid with total HCl neutralizing capacity 177.8 mmol/day. All treatments were continued for 8 weeks. Ten patients at the 4th week and 21 patients at the 8th week were excluded because of protocol violation. There is no statistical difference in the healing rates in group I versus II, group I versus III at both the 4th and the 8th week, group II versus group III at the 4th week. The low dose antacid group IV had less healing than the standard dose antacid group III (p < 0.05), and group III patients also had a significantly higher healing rate than group II patients at the 8th week (p < 0.02). There is no difference in symptomatic relief among the four groups of patients. The smokers had a significantly lower healing rate than the nonsmokers at the 8th week (62.6% vs. 82%, p < 0.05). After initial healing of ulcers at the 4th week, ten patients had recurrent ulcers at the 8th week, these patients were 10 years younger than patients with healed ulcers both at the 4th and the 8th week. From our results, we suggest that antacids should be used in standard doses, but the H2 antagonist can be employed initially with a low dose.