臨牀消化器内科 Vol.20 No.8(2-3)


特集名 PPI・H2RAの使い分け
題名 作用特性 (3) 反跳現象出現におけるPPI・H2RAの比較
発刊年月 2005年 07月
著者 小林 隆 藤田保健衛生大学第二教育病院内科
著者 芳野 純治 藤田保健衛生大学第二教育病院内科
著者 乾 和郎 藤田保健衛生大学第二教育病院内科
著者 若林 貴夫 藤田保健衛生大学第二教育病院内科
著者 奥嶋 一武 藤田保健衛生大学第二教育病院内科
著者 神谷 直樹 藤田保健衛生大学第二教育病院内科
【 要旨 】 ヒスタミンH2受容体拮抗薬 (H2RA) とプロトンポンプ阻害薬 (PPI) の投与中止後における酸分泌反跳現象について,文献的考察を踏まえて概説した.H2RAの投与中止後の酸分泌反跳現象には,ヒスタミン受容体の機能調節機構レベルでの変化が影響していると考えられ,とくに夜間の酸分泌反跳現象は潰瘍再発の一因であるとされた.一方,PPI投与後の酸分泌反跳現象は発生しないという報告が多かったが,大量かつ長期に投与した後にはこの現象が発生する可能性を示唆する報告が認められた.しかし,現時点では本邦における常用投与量でPPIを使用した場合,この現象の発生は可能性がきわめて少ないと考えられた.
Theme Comparison of PPIs and H2RAs in the Actions and Suitable Use for the Diseases
Title Comparison of Rebound Phenomenon in H2RAs and PPIs
Author Takashi Kobayashi Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
Author Junji Yoshino Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
Author Kazuo Inui Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
Author Takao Wakabayashi Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
Author Kazumu Okushima Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
Author Naoki Kamiya Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine
[ Summary ] We produced an outline concerning the intragastric acid rebound phenomenon when cancelling administration of a histamine H2 receptor blocking agent (H2RA) and proton pump inhibitor (PPI). The change produced by a function regulatory mechanism level of histamine receptors seemed to influence acid rebound, which occurred after cancellation of H2RA administration. It was also supposed that acid rebound occuring at night in was a particular cause of ulcer recurrence. On the other hand, in the case of intragastric acid rebound phenomenon with the cancellation of PPI administration, there have been a few reported cases. However, there have been many reports on acid rebound occurring. It seemed that there has been very little likelihood of outbreaks of this phenomenon when using PPIs with normal dosages in Japan.
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