三联疗法联合加味乌贝散治疗幽门螺杆菌引起小儿消化性溃疡93例临床观察

Clinical observation of triple therapy combined with jiaweiwubeisan in treating 93 cases of peptic ulcer caused by Helicobacter pylori

目的探讨阿莫西林、克拉霉素、奥美拉唑联合中药加味乌贝散治疗幽门螺杆菌(Hp)引起小儿消化性溃疡的临床疗效。方法采用单盲随机法将确诊的186例患儿随机分为对照组和治疗组,各93例。对照组采用西药三联疗法(阿莫西林+克拉霉素+奥美拉唑),治疗组在对照组治疗基础上加用加味乌贝散,连续用药7 d为1个疗程,4个疗程后统计临床疗效、Hp根除率、溃疡愈合时间和质量、临床症状积分,并对治疗6月和1年后不良反应率和复发率进行随访。结果治疗组治愈率和总有效率分别为58.06%和93.55%,显著高于对照组(P<0.05);治疗4周后嗳气、腹痛、腹胀和反酸临床症状积分显著低于对照组(P<0.05);治疗组溃疡愈合时间和Hp根治时间分别为(4.45±1.76)周和(8.91±2.11)d,显著低于对照组(P<0.05);溃疡愈合率和Hp根治率分别为94.62%和93.54%,显著高于对照组(P<0.05)。治疗组总不良反应发生率为9.68%,显著低于对照组的16.13%(P<0.05),1年随访复发率为10.75%,显著低于对照组的17.20%(P<0.05)。结论三联疗法联合加味乌贝散可有效缓解Hp阳性的儿童消化性溃疡;缓解患儿临床症状,根除Hp感染,缩短愈合溃疡时间,提高愈合质量,不良反应少,复发率低。

Objective To investigate the clinical effect of amoxicillin, clarithromycin, omeprazole and tradi- tional Chinese medicine jiaweiwubeisan in treating pediatric peptic ulcer caused by Helicobacter pylori （Hp）. Methods A randomized single blind method was used to put 186 cases into treatment group and control group, 93 cases in each group. The control group was treated with triple therapy （omeprazole＋amoxicillin＋clarithromycin） , the treatment group was treated with triple therapy I omeprazole＋amoxicillin＋clarithromycin ） and j iaweiwubeisan, continuous 7 days for 1 course. After 4 courses, clinical efficacy was analyzed statistically. Including the eradica- tion rate of Hp, ulcer healing time and quality, clinical symptom score, and the patients were followed up 6 months or I year after for bad response rate and recurrence rate. Results In the treatment group, the cure rate and total effective rate were 58.06% and 93.55% respectively, significantly higher than in the control group { P〈0.05 ） ; after 4 weeks of treatment, clinical symptom score in treatment group including belching, abdominal pain, abdomi- nal distension and regurgitation was significantly lower than that in the control group （P〈0.05 ） ;ulcer healing time and Hp eradication time was （4.45±1. 76） weeks and （8.91±2.11 ） days, significantly lower than in the control group （ P〈0.05 ） ; ulcer healing rate and cure rate of Hp were 94.62% and 93.54% , significantly higher than in the control group （ P〈0.05 ）. The total adverse reaction rate in the treatment group was 9.68%, significantly lower than 16.13% in the control group （P〈0.05） , during 1 year follow-up, the recurrence rate was 10.75%, signifi- cantly lower than 17.20% in the control group （ P〈0.05 ）. Conclusion Triple therapy combined with jiaweiwu- beisan can effectively alleviate the clinical symptoms caused by Hp positive peptic ulcer, eradicate Hp infection, shorten ulcer healing time, improve the quality of ulcer healing, with less side effects and low recurrence rate.