猴头菌提取物颗粒治疗小儿幽门螺杆菌相关性慢性浅表性胃炎临床研究

Clinical Study of Hericium Extractive Grannla on Chronic Superficial Gastritis Associated by Helicobacter Pylori

目的:评价猴头菌提取物颗粒联合质子泵抑制剂(PPI)及胃粘膜保护剂对幽门螺杆菌(Hp)相关性慢性浅表性胃炎的临床症状改善、Hp根除率、内镜下粘膜变化及组织学炎症改变的影响。方法:对我院2006年6月～2008年6月2年间消化内科门诊就诊的120例Hp感染的慢性浅表性胃炎患儿采用随机平行对照临床研究。随机分为阿莫西林+克拉霉素+奥美拉唑根治组(经典根治组)、猴头菌提取物颗粒+奥美拉唑+铝碳酸镁治疗组、猴头菌提取物颗粒治疗组、铝碳酸镁+奥美拉唑治疗组,每组各30例,疗程均为4周。结果:两疗程治疗结束,4组临床症状改善变化均有差异,经典根治组与猴头菌提取物颗粒联合PPI治疗组临床症状改善较其它组明显,第8周末复查胃镜及幽门螺杆菌,其根除率及镜下粘膜改变、组织学炎症消退情况猴头菌提取物颗粒联合治疗组较经典根治组差异有统计学意义(P<0.05);与猴头菌提取物颗粒单用组及铝碳酸镁+奥美拉唑(PPI)治疗组比较差异有统计学意义(P<0.05)。结论:猴头菌提取物颗粒联合抑酸剂及胃粘膜保护剂治疗Hp相关性慢性浅表性胃炎疗效明显,尤其在改善临床症状及镜下表现与经典的根治Hp治疗方案效果相当,但Hp根治率及组织学改变稍逊于经典治疗组,猴头菌提取物颗粒剂型及口感适合儿童服用,故对于抗生素过敏或耐药的Hp相关性胃炎患儿选择此方案,经济有效,值得推荐。

Objective： To evaluate the therapeutic effect of the Hericium Extractive Granula with proton pump inhibitor （PPI） and gastric mucous membrane protective agent against Helicobacter pylori （Hp） associated chronic superficial gastritis, including the improvement of clinical symptoms, Hp eradication rate, endoscopic survey changes and the development of anatomy. Methods： From June 2006 to June 2008 we took a parallel randomized controlled clinical study for the 120 cases of Hp associated chronic superficial gastritis in children who visited the outpatients＇ Department of the Digestion. They were randomly divided into a radical cure group using amoxicillin＋elarithromyein ＋Omeprazole, a group using Hericium Extractive Grantda＋Omeprazole＋Hydrotalcit, a group using only Herieium Extractive Granula, and a group using Hydrotalcit＋Omeprazole, each of 30 cases, in a treatment course of 4 weeks. Results： After two courses of the treatment, the improvement of clinical symptoms in the 4 groups was different, among which, the classic radical group and the group using Hericium Extractive Granula ＋ PPI improved more significantly than the other groups. Review of endoscopy and Helicobaeter pylori at the end of the 8th week showed that the eradication rate, endoscopic mucosal changes and the subsiding of the histological inflammation in the group using Hericium Extractive Granula ＋ PPI were more statistically significant （P 〈 0.05 ） than in the classical radical group; and also more statistically different than the group using only Hericium Extractive Granula and the group using Hydrotalcid ＋ Omeprazole （ P 〈 0.05 ）. Conclusions：The therapeutic effect of the Hericium Extractive Granula with acid-suppressing agents and gastric mucous membrane protective agents against Hp associated chronic superficial gastritis was significant, particularly in improvement of clinical symptoms and endoscopic features. It was no worse than that in the classic radical cure group against Hp, but in the cure rate of Hp and the changes of organizations the former was not as good as the latter. Furthermore, the shape and taste of Hericium Extractive Granula is suitable for children, so it is economic and effective, and recommendable for those children patients allergic to antibiotics or resistant to the Hp-associated gastritis.