| Peptic ulcer is the ulcer in stomach or duodenum. It is a common and multiple disease of digestive system and the morbidity is about 10%. The pathogenesis is multifactorial. It is supposed that the pathogenesis of peptic ulcer is the disorder between protective factors in mucosa that is more important to peptic ulcer. Aggressive factors include gastric acid, pepsin, bile salt, Helicobacter pylori and drugs. Among these factors Hp and gastric acid are most important. Antacid therapies have gone through alkaline drugs, H2 receptor antagonist, proton pump inhibitors. PPIs have strong and steady work of antacid, more over they have the action of against Hp. So at present they are the first choice to treat peptic ulcer. Rabeprazole is a new proton pump inhibitor, it works rapid, its action last and steady, CYP2C19 doesn't metabolize it and has less side effect .So it is the best proton pump inhibitor now.In order to observe the curative effect and side effect of new proton pump inhibitor-Rabeprazole and compare with omeprazole and Ranitidine. From April 2002 to January 2004,totally 297 cases of peptic ulcer patients were enrolled. Patients were randomly allocated into Rabeprazole treatment group 101 cases and omeprazole control group 100 cases, ranitidine control group 96 cases. Give the treatment group rabeprazole 10 mg qd. Give the Omeprazole control group omeprazole 20 mg qd. And give the ranitidine control group ranitidine 150 mg bid. The whole course lasted four weeks. Recorded the alleviation of the digestive system and the side effect of drugs. At the end of the course reexamined gastroscope on every patient, Result: the alleviate rate of clinical symptoms, Rabeprazole group is better than omeprazole group and omeprazole group is better than ranitidine group. In the first treament day rabeprazole compared with omeprazole is statistically significant. The vanishing rate of the pain, rabeprazole is better than omeprazole especially in the first three days of treament, rabeprazole and omeprazole are all better than ranitidine. But rabeprazole and omeprazole was not statistically in ulcer healing rate, they were better than ranitidine. Conclusive: rabeprazole works rapid, its action last and steady, and it has less side effect. Ulcer healing rate is not statistically significant in rabeprazole and omeprazole. They were better than ranitidine in the symptom relief and healing rate. Discussion: Rabeprazole works rapid because it activates faster than omeprazole. After 5 minutes of taking in rabeprazole almost completely inhibits the activity of H+-K+-ATPase. The study has shown that the 24-h acidity of day 1 was significantly decreased for rabeprzole compared with omeprazole at which intragastric pH> and pH>. On day 8,the decrease in 24-h intragastric acidity was greater with rabeprazole than with omeprazole, but the difference was not statistically significant. In pharmacokinetics rabeprazole is different from other PPIs. Other PPIs are mainly metabolized by cytochromes P450 2C19 and 3A4. Genetic polymorphism of cytochrome P450 CYP2C19 has two types –extensive metabolisers and poor metabolisers. Because CYP2C19 does not affect the mtabolism of rabeprazole, in different human groups the difference of it is little. The mechamism of PPIs anti Hp was considered to be blockage of the SH groups of Hp urease and inhibit Hp producing urease. Some people consider that the H+-K+-ATPase in the Hp was similarity with the H+-K+-ATPase in the human's, so they were inhibited at the same time.
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