Viewing the clinical application of H2 receptor antagonists from the consensus of the guidelines

Author: Zou Yali Dengzhou Central Hospital This article is authorized by the author to publish by Yimaitong, please do not reprint without authorization.

Introduction In recent years, the clinical application of proton pump inhibitors (PPI) has been over-indications, over-dose, over-the-course medication, and improper use of drug combinations, which increase the risk and economic burden of patients' medication.

Medical insurance restricts PPI injection preparations to be reimbursed for patients who have diagnoses of diseases indicated in the instructions and who have fasting medical advice or have difficulty swallowing; in December 2020, the National Health Commission issued the "Guiding Principles for the Clinical Application of Proton Pump Inhibitors", further Standardize the clinical application of PPI.

In this context, the use of H2 receptor antagonists (H2RA) has gradually increased.

So, can H2RA replace the clinical application of PPI? The application recommendations for acid inhibitors and H2RA for different diseases are summarized below for common acid-related diseases, upper gastrointestinal bleeding, and stress mucosal lesions (click to view the enlarged picture): Table 1 Common acids Recommendations for the application of acid inhibitors and H2RA for related diseases Table 2 Recommendations for the application of acid inhibitors and H2RA for upper gastrointestinal bleeding Table 3 Recommendations for the application of acid inhibitors and H2RA for stress mucosal lesions Summary of the above, H2RA The acid suppression effect of PPI is inferior to PPI and cannot replace the clinical application of PPI.
The consensus guidelines still recommend PPI as the first choice in the treatment of acid-related diseases and upper gastrointestinal bleeding and the prevention of stress mucosal lesions, but H2RA can be used for mild to moderate Symptomatic GERD, mild to moderate chronic gastritis without Helicobacter pylori infection, can also be used for upper gastrointestinal bleeding if PPI is not available in time.References (slide down): [1] Chinese Medical Association Gastroenterology Branch.
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