Currently, the most commonly used medications are divided into the following categories:
1, inhibit gastric acid secretion drugs:
Currently, there are H2 receptor antagonist (H2-RA) and proton pump inhibitor (PPI).H2-RA can inhibit basic and stimulated gastric acid secretion; commonly used such as cimetidine, ranitidine, famotidine and nizatidine; PPI acts on mural cell gastric acidity. H2-RA can inhibit basic and stimulated gastric acid secretion, commonly used such as cimetidine, ranitidine, famotidine and nizatidine; PPI acts on the key enzyme H+-K+ ATPase in the final step of gastric acid secretion in the mural cells, making it irreversibly inactivated, with stronger and more persistent acid-suppressing effects.PPI promotes faster ulcer healing and higher healing rate, and is suitable for various refractory ulcers or NSAID ulcers. It is suitable for the treatment of various refractory ulcers or NSAID ulcers when patients can not stop NSAID, and it can also be used for the eradication of Helicobacter pylori treatment with the synergistic effect of antibiotics, so it is the first choice of medicine for gastric ulcers. Commonly used PPIs are omeprazole, lansoprazole, rabeprazole, esomeprazole, epprazole and so on.
2, mucosal protective agent:
Currently does not belong to the treatment of ulcers of the first line of drugs, but with acid suppression drugs, it can improve the quality of ulcer healing, reduce the recurrence of ulcers, common such as aluminum thioglycollate, colloidal bismuth, bismuth citrate, potassium bismuth, misoprostol and so on.
3, gastrointestinal power drugs:
Mainly used for nausea, vomiting, abdominal distension and other symptoms of patients in order to promote gastrointestinal emptying, relieve the symptoms.
Eradication of Helicobacter pylori treatment As mentioned earlier, Helicobacter pylori is one of the important reasons for the occurrence of gastric ulcers, so Helicobacter pylori positive patients should be eradicated Helicobacter pylori treatment, which not only promotes the healing of the ulcers, but also prevents the recurrence of the ulcers, so as to completely cure the ulcers.
There is no single drug that can effectively eradicate H. pylori, so a combination of drugs is necessary. In recent years, the international anti-Helicobacter pylori related guidelines and *** knowledge, the recommended first-line treatment program is based on PPI plus two antibiotic triple therapy program, the course of treatment 7d ~ 14d. Clinical confirmation of its high efficacy, tolerance and compliance and other advantages. Antibiotics with the role of killing H. pylori are clarithromycin, amoxicillin, metronidazole (or tinidazole), tetracycline, furazolidone, certain quinolones such as levofloxacin, etc. PPI and colloidal bismuth in vivo can inhibit H. pylori, and with the above antibiotics have a synergistic bactericidal effect. The treatment course of ulcer is usually 4-6 weeks, some need to maintain 8 weeks, the first 2 weeks is usually the eradication of Helicobacter pylori, and then continue to be given to inhibit the secretion of gastric acid and protect the gastric mucosa of the drug consolidation therapy. Because the treatment cycle is relatively long, so patients need to actively cooperate, adhere to the medication, only in this way can effectively control the condition of gastric ulcer.
Surgery Currently, the treatment of ulcer disease has been quite mature, and general ulcers do not need to be treated by surgery, but only in the following conditions: hemorrhage can not be controlled by drugs; perforation; scar pyloric obstruction; refractory ulcers that are ineffective in the treatment of drugs; and highly suspected of cancer
This is the first time that patients have been treated for gastric ulcers.