消化性潰瘍の維持療法に関する臨床的検討

Abstract

Two hundred-forty-nine gastric ulcer (GU) patients and 113 duodenal ulcer (DU) patients found in a gastric mass survey were available for this study. A combination regimen of H₂ blocker and mucosal-protective agents was administered in the initial treatment and maintenance therapy (MT). During maintenance therapy, after S₁ scar (red scar) and S₂ scar (white scar) had been confirmed, S₂ healing rate and shifting rate from S₁ to S₂ were calculated. On the other hand, in case of recurrence of ulcer, recurrence rate was calculated. After maintenance therapy, recurrence rates were compared with the scar stage at the end of MT and the length of MT. Results : S₁ healing rate was 84.0% (3 M) in GU and 83.2% (3 M) in DU and the shifting rate from S₁ to S₂ was 63.8% (3 M), 82.3% (6 M) in GU and 65.6% (3 M), 89.2% (6 M) in DU. Recurrence rate from S₁ was 35% (3 M) and 70% (6 M) in GU, almost the same pattern as DU. Shifting rate from S₁ to S₂ in maintenance therapy was significantly lower in intractable ulcer than easily healing ulcer in GU and DU. Recurrence rate after long-term maintenance therapy was significantly lower than that of short term in GU and DU. Recurrence rate from S₁ was significantly higher than that of S₂ in intractable GU. In long-term MT and S₂ at the end of MT, the recurrence rate was relatively low in intractable DU. Conclusion : At least 6 months and sufficiently 12 months MT was nessesary to confirm S₂. In the prevention of recurrence after MT, long-term MT was more effective than short-term and it was necessary that S₂ should be confirmed at the end of MT in intractable GU and DU. In early relapsing ulcer from S₁ at the early period of MT, it was considered that half the therapeutic dose of H₂ blocker was insufficient.