小剂量克拉霉素三联疗法根除儿童消化性溃疡幽门螺杆菌

Small Dose of Clarithromycin Triple Therapy for Eradication of Helicobacter Pylori in Childhood Peptic Ulcer

目的:研究克拉霉素不同剂量的三联疗法对消化性溃疡患儿的幽门杆菌(HP)根除和疼痛缓解的疗效及不良反应。方法:采用大剂量(A组)和小剂量(B组)克拉霉素的PPI三联疗法并与含羟氨苄青霉素(C组)的PPI三联疗法组进行对比的前瞻性研究。结果:HP根除率A组为92.3%(12/13)B组为91.6%(11/12)C组为90%(9/10)。3组间无显著性差异(P>0.05)。A、B和C各组治疗后3 d及1周时腹痛缓解程度与治疗前相比均有显著性差异(P<0.05);但3组之间在治疗后腹痛缓解程度均无显著性差异(P>0.05)。主要不良反应是恶心、呕吐、食欲差和轻度腹泻,个别有异味感。不良反应总的发生率为17.1%,其中A组为23.1%,B组为8.3%,C组为20.0%,B组与A组、C组间均有显著性差异(P<0.05)。结论:根除HP的PPI三联疗法中,均以含克拉霉素的根除率高且含小剂量克拉霉素的PPI三联疗法是在儿童中较佳的根除方案。

Objective ：To research the efficacy and adverse reactions of the eradication and the pain relief in the different doses of clarithromycin triple therapy on Helicobacter pylori in children with peptic ulcer （HP）. Methods：The large dose （ A group ） and low dose （ B group ） PPI triple therapy of clarithromycin and amoxicillin - containing （ C group） of PPI triple therapy group prospective study. Results：As for the Eradication rate of HP, the group A is 92. 3% （12/13）, the group B is 91.6% （11/12）, the group C is 90% （9/10）. There is no notable difference among the three groups（P 〉0.05）. And for three days and one week after treatment of the group A,B and C, the degree of abdominal pain before treatment is significantly different（ P 〈 0. 05 ） ;however, the degree of abdominal pain after treatment of the three group makes no outstanding difference （P 〉 0. 05 ）. The main adverse reactions are nausea, vomiting, poor appetite and mild diarrhea, peculiar smell individually. The total incidence of adverse reactions is 17. 1% , among which group A is 23.1% , group B is 8.3% , group C is 20. 0% ;the group B has distinguished differences with the group A and C（P〈 0. 05 ）. Conclusions：In the PPI triple therapy for HP eradication, the program with high eradication rate in elarithromyein and containing small doses of PPI triple therapy of elarithromycin is the better one.