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目的：探讨低剂量兰索拉唑长期抑酸维持治疗预防十二指肠球部溃疡复发的有效性。方法：将经４周兰索拉 唑３０ｍｇｑｄ治疗进入瘢痕期的６７例十二指肠球部溃疡患者随机分入两个治疗组：组Ⅰ：兰索拉唑１５ｍｇｑｄ，维持 ３个月；组Ⅱ：兰索拉唑１５ ｍｇ ｑｄ，维持６个月。在维持治疗开始后第３、６、９、１２个月末和出现溃疡复发症状时复查胃 镜，并在维持治疗结束后胃镜检查时取胃液及胃粘膜测定胃液ｐＨ、总酸度、胃蛋白酶及胃粘膜氨基己糖含量。结 果：经１年追踪随访，组 Ⅰ和组Ⅱ患者的溃疡一年累积复发率分别为２０．６％（７／３４）和２１．２％（７／３３），两组间差异无 显著性。溃疡复发患者的胃液总酸度和胃蛋白酶含量高于未复发者，ｐＨ值和胃粘膜氨基己糖含量低于未复发者， 差异均有显著性。红色瘢痕期（Ｓ１期）溃疡患者的复发率高于白色瘢痕期（Ｓ２期）患者，吸烟者的复发率高于不吸烟者。 ４例幽门螺杆菌阴性溃疡患者无１例复发。结论：３个月或６个月低剂量兰索拉唑维持治疗可有效预防十二指肠球 部溃疡复发，其作用是通过抑制胃酸实现的。
Objective: To investigate the effectiveness of low-dose lansoprazole long-term acid suppression maintenance in preventing recurrence of duodenal ulcer. METHODS: Sixty-seven patients with duodenal ulcer that entered the scar stage after 4 weeks of lansoprazole 30 mg qd were randomized into two treatment groups: Group I: lansoprazole 15 mg qd for 3 months; Group II : Lansoprazole 15 mg qd, for 6 months. Gastroscopy was performed at the end of the 3rd, 6th, 9th, and 12th months after the treatment was started and the symptom of ulcer recurrence was observed. Gastric juice and gastric mucosa were taken after gastroscopy at the end of maintenance treatment. Gastric pH, total acidity, pepsin and gastric mucosa Hexose content. Results: The cumulative recurrence rates of ulcers in group Ⅰ and group Ⅱ after one year follow-up were 20.6% (7/34) and 21.2% (7/33), respectively, with no significant difference between the two groups . Gastric ulcer recurrence in patients with total acidity and pepsin content was higher than those without recurrence, pH and gastric mucosal hexosamine content was lower than those without recurrence, the difference was significant. The recurrence rate was higher in patients with red scar stage (stage S1) ulcer than in white scar stage (stage S2), and the recurrence rate was higher in smokers than in nonsmokers. No recurrence occurred in 4 cases of Helicobacter pylori negative ulcer. Conclusions: Lansoprazole maintenance therapy at 3 months or 6 months can effectively prevent the recurrence of duodenal ulcer. Its effect is through the inhibition of gastric acid.