综述文章:藻酸盐筏制剂治疗胃灼热和胃酸反流。
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Mandel KG, Daggy BP, Brodie DA, Jacoby HI
综述文章:藻酸盐筏制剂治疗胃灼热和胃酸反流。
营养药物学报，2000;14(6):669-90。
- PubMed ID
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10848650 (PubMed视图］
- 摘要
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海藻酸盐为基础的筏形成配方已经在世界范围内销售了30多年，以各种品牌命名，包括Gaviscon。它们被用来对症治疗胃灼热和食管炎，并且似乎通过一种不同于传统抗酸剂的独特机制起作用。在胃酸的存在下，海藻酸盐沉淀，形成凝胶。以海藻酸盐为基础的筏形配方通常含有碳酸氢钠或碳酸氢钾;在胃酸存在的情况下，碳酸氢盐被转化为二氧化碳，二氧化碳被困在凝胶沉淀物中，将其转化为漂浮在胃内容物表面的泡沫，就像漂浮在水面上的筏子一样。体外和体内研究都表明，海藻酸盐基筏可以捕获二氧化碳，以及某些配方中含有的抗酸成分，从而提供相对ph中性的屏障。几项研究表明，在胃食管反流发作时，藻酸盐筏可以优先进入食管酸性胃内容物的位置或前方;一些研究进一步表明，木筏可以作为一个物理屏障，以减少反流发作。虽然一些以海藻酸盐为基础的配方也含有抗酸成分，可以提供显著的酸中和能力，但这些配方减轻胃灼热症状的功效似乎并不完全依赖于胃内容物的中和。藻酸盐筏子的强度取决于几个因素，包括筏子中产生和捕获的二氧化碳量，藻酸盐的分子特性，以及配方中抗酸成分中铝或钙的存在。 Raft formation occurs rapidly, often within a few seconds of dosing; hence alginate-containing antacids are comparable to traditional antacids for speed of onset of relief. Since the raft can be retained in the stomach for several hours, alginate-based raft-forming formulations can additionally provide longer-lasting relief than that of traditional antacids. Indeed, clinical studies have shown Gaviscon is superior to placebo, and equal to or significantly better than traditional antacids for relieving heartburn symptoms. Alginate-based, raft-forming formulations have been used to treat reflux symptoms in infants and children, and in the management of heartburn and reflux during pregnancy. While Gaviscon is effective when used alone, it is compatible with, and does not interfere with the activity of antisecretory agents such as cimetidine. Even with the introduction of new antisecretory and promotility agents, alginate-rafting formulations will continue to have a role in the treatment of heartburn and reflux symptoms. Their unique non-systemic mechanism of action provides rapid and long-duration relief of heartburn and acid reflux symptoms.