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消化性溃疡(PU)是一种常见的慢性病,根据胃镜统计资料,PU检出率为19％～33％。第九届世界胃肠病学大会报告:在发展中国家的成人中占80％～90％,在发达国家也高达50％～60％。此病发现到现在已达200年,为解决其发病病因、发病机制和寻求有效治疗方法,多年来作了大量的研究,但尚未能彻底解决。 1910年,Schwarz提出“无酸无溃疡”的观点,认为PU的发生是由于胃的消化分泌液和胃酸损害所致。70年代初Black证实胃酸分泌主要由壁细胞上组胺受体的一种亚型(H_2受体)所介导,随之H_2受体拮抗剂(H_2-RA)甲氰咪胍等问世,H_2-RA用于临床PU的治疗取得突破。80年代质子泵抑制剂(PPI)问世,治疗PU较H_2-RA更优,H_2-RA和PP1有很强的抑制胃酸分泌和抗溃疡作用。据报道H2-RA治疗4周十二指肠溃疡(DU)愈合率为80％～95％,胃溃疡(GU)为70％～85％,8周DU愈合率为90％～100％,GU为80％～95％,PP1的疗效更佳。难治性溃疡大为减少。但一经停药,多数病例最终难免复发,年复发率为50％～90％。溃疡病复发仍是有待解决的难题。
Peptic ulcer (PU) is a common chronic disease, according to gastroscope statistics, PU detection rate of 19% to 33%. Report of the Ninth World Gastroenterology Conference: 80% -90% of adults in developing countries, and up to 50% -60% in developed countries. It has been 200 years since the disease was found. To solve its etiological factor, pathogenesis and seek effective treatment, a great deal of research has been done over the years, but it has not yet been completely solved. In 1910, Schwarz put forward the idea of “acid-free and ulcer-free”, believing that PU occurs due to gastric digestive secretions and gastric acid damage. In the early 1970s, Black demonstrated that gastric acid secretion was mainly mediated by a subtype of histamine receptor on parietal cells (H 2 receptor), followed by the advent of H 2 -receptor antagonist (H 2 -RA) -RA breakthrough for the treatment of clinical PU. The proton pump inhibitor (PPI) appeared in the 80s, the treatment of PU better than H_2-RA, H_2-RA and PP1 have a strong inhibitory effect of gastric acid secretion and anti-ulcer. It has been reported that the healing rate of duodenal ulcer (DU) is 80% -95%, the gastric ulcer (GU) is 70% -85% and the healing rate of DU is 8% by 90% ~ 100% 80% to 95%, PP1 better effect. Refractory ulcer greatly reduced. However, once discontinued, the majority of cases eventually inevitable recurrence, the annual recurrence rate of 50% to 90%. Canker disease is still a problem to be solved.