| 特集名 | PPI・H2RAの使い分け | |
|---|---|---|
| 題名 | pHモニタリングからみた使い分け (2) 逆流性食道炎治療効果とPPI・H2RAの使い分け | |
| 発刊年月 | 2005年 07月 | |
| 著者 | 黒澤 進 | 埼玉医科大学総合医療センター消化器肝臓内科 |
| 著者 | 大野 志乃 | 埼玉医科大学総合医療センター消化器肝臓内科 |
| 著者 | 川島 淳一 | 埼玉医科大学総合医療センター消化器肝臓内科 |
| 著者 | 中村 孝司 | 埼玉医科大学総合医療センター消化器肝臓内科 |
| 著者 | 屋嘉比 康治 | 埼玉医科大学総合医療センター消化器肝臓内科 |
| 【 要旨 】 | 胃食道逆流症 (GERD) の薬物治療の二本柱である酸分泌抑制薬のヒスタミンH2受容体拮抗薬 (H2RA) とプロトンポンプ阻害薬 (PPI) は，作用機序，吸収，代謝などの薬物特性などがまったく異なっている．長期投与で強力な酸分泌抑制を示すPPIがGERDの治療に適しているが，軽症のGERDではH2RAも有効である．内視鏡陰性GERDでは症状の軽快が治療のゴールであり，PPIとともにH2RAにもオンデマンドを中心にした使い方に期待がもてる． | |
| Theme | Comparison of PPIs and H2RAs in the Actions and Suitable Use for the Diseases | |
|---|---|---|
| Title | Role of H2RA and PPIs in GERD Treatment | |
| Author | Susumu Kurosawa | Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical School |
| Author | Shino Ohno | Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical School |
| Author | Junichi Kawashima | Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical School |
| Author | Takashi Nakamura | Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical School |
| Author | Koji Yakabi | Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical School |
| [ Summary ] | H2RAs and PPIs are the mainstays of medical treatment for GERD. Both drugs reduce gastric acid output through different pathways. Moreover, their absorption distribution and excretion are also different. PPIs have potent acid blocking qualities, especially taken in repeated dosees. Therefore, PPIs are recommended for rather severe cases of GERD. On the other hand, H2RA possess rapid, as well as the strongest acid-blocking capacity, with the initial dose. However, the decrease of potency with repeated doses, known as tolerance, has not been determined. Therefore, H2RAs are well suited for midlevel GERD treatment. The treatment goal for endoscopy negative GERD therapy is to relieve symptoms. PPIs, as well as H2RAs, can be useful for on-demand treatment of GERD. |
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