The Efficacy of Combined Omeprazole and Ranitidine Therapy in Patients with Duodenal Ulcer

Objective:To investigate the efficacy of varied doses of Omeprazole(OME) alone or in combination of Ranitidine(RAN) for acid secretion,especially the nocturnal acid breakthrough(NAB) in patients with active duodenal ulcer,and impacts of HP on the treatment efficacy.Methods: 74 patients with duodenal ulcer confirmed by gastroscopy were randomized to one of the four treatment groups: group A(omeprazole 20 mg daily,n=13),group B(omeprazole 20 mg twice a day,n=37),group C(omeprazole 40 mg iv per 12 hours,n=11) and group D(receiving treatment as described in group B,with additional oral ranitidine 150 mg at bedtime,n=13).Twenty-four hour intragastric pH-metry was performed on day 5.Results: Significant differences in the mean and median values of 24h and night-time intragastric pH,percentage of hours below pH 4 as well as incidence of NAB(group A=76.9%,group B=24.3%,group C=18.2%,group D=7.7%) were found between group A and the other 3 groups(P0.001),which showed no difference between one another(P0.05).Compared with HP-negative patients within a same treatment group,the mean and median values of 24h and night-time intragastric pH,percentage of hours below pH 4 were lower in those with positive HP results.The incidence of NAB was lower in HP-positive patients compared with hp-negative ones(13.7% vs 44.1%,P0.05),and in all treatment groups,HP-positive patients experienced less NAB than those with negative HP.Infection with HP was not related to NAB in the other 3 groups.Conclusion: omeprazole therapy showed effects on acid suppression in a dose-dependent pattern.Combination of ranitidine tended to reduce the incidence of NAB.Patients with HP infecuion experienced better efficacy with OME therapy.