三联疗法治疗小儿HP相关性胃炎的临床研究

目的探讨克拉霉素、甲硝唑、奥美拉唑三联疗法治疗小儿幽门螺杆菌(Hp)相关性胃炎的效果。方法将200例经胃镜检查诊断为胃炎、十二指肠溃疡或胃溃疡且经13C呼气试验检查呈阳性小儿作为观察对象。随机平分成两组,治疗组给予克拉霉素颗粒剂20mg/(kg.d),2次/d;对照组给予阿莫西林胶囊50mg/(kg.d),3次/d。两组疗法中均加用甲硝唑15mg/(kg.d),2次/d和奥美拉唑0.8mg/(kg.d),两组患者的疗程均为1个月。观察治疗前后患儿症状、体征变化和不良反应发生情况。结果两组患者的腹痛缓解率、溃疡愈合率及Hp根除率方面疗效相似,但治疗组的疗效比对照组稍好,而且腹痛消失时间前者也优于后者,P<0.05,具有统计学意义,无明显不良反应发生。结论克拉霉素,甲硝唑,奥美拉唑三联疗法具有药物剂量小、疗程短、疗效高、不良反应小等优点,值得临床进一步研究推广应用。

Objective To investigate the clarithromycin, metronidazole, omeprazole triple therapy in children with Helicobacter pylori （Hp）-associated gastritis Results. Methods 200 cases diagnosed by endoscopy gastritis, duodenal ulcer or gastric ulcer, and by the 13C breath test-positive children as an object of observation. Randomly divided into two groups, the treatment group： clarithromycin granules 20 mg / （kg·d）, 2 times/d; control group： amoxicillin 50 mg / （kg＇ d）, 3 times / d. Therapy groups were added with metronidazole 15 mg / （kg·d）, 2 times / d and omeprazole 0.8 mg / （kg·d）, two groups of patients were 1 month of treatment. Observed before and after treatment in children with symptoms, signs, and adverse events. Results There were response rate in patients with abdominal pain, ulcer healing and Hp eradication rate similar efficacy rate, but the efficacy of the treatment group was slightly better than the control group, and abdominal pain is also the time the former than the latter, P〈0.05, statistically significance, no significant adverse reactions. Conclusion The Clarithromycin, metronidazole, omeprazole triple therapy with a small dose, short course, high efficacy, adverse reactions, etc, and it is worthy of further research and promotion applications.