四种药物序贯疗法根除儿童幽门螺杆菌感染的临床效果观察

Clinical efficacy of four kinds drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori infection of children

目的 探讨四种药物口服10 d序贯疗法治疗儿童幽门螺杆菌（Hp）感染的临床效果和安全性.方法 入选我院2012年12月至2014年4月130例Hp感染患儿,按照随机、对照原则分为两组,各65例.观察组采用四种药物口服10 d序贯疗法,即前5d予以奥美拉唑、阿莫西林-克拉维酸钾治疗,后5d予以奥美拉唑、克拉霉素及甲硝唑治疗.对照组采用标准三联法治疗,即予以奥美拉唑、克拉霉素及阿莫西林-克拉维酸钾治疗10 d,疗程结束后1个月采用14C尿素呼气试验评价和比较Hp根除率及治疗有效率,记录不良反应情况.结果 观察组有效率93.8％ （61/65）显著高于对照组75.4％ （49/65）,Hp根除率90.8％ （59/65）也显著高于对照组67.7％ （44/65）,两组比较差异均有统计学意义（x2值分别为8.51、10.52,P均＜0.05）;不良反应发生率为10.8％（7/65）,低于对照组15.4％（10/65）,但两组比较差异无统计学意义（x2=0.61,P＞0.05）.结论 四种药物口服10 d序贯疗法治疗儿童Hp感染临床效果显著,有效提高Hp根除率,相对安全,值得临床推广.

Objective To investigate the clinical efficacy and safety of four kinds of drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori （Hp） infection of children.Methods One hundred and thirty children with Hp infection in the First Hospital of Datong from Apr.2013 to Apr.2014 were randomly divided into two groups with 65 cases in each group.Patients in the observation group were treated with four kinds of oral drug 10 d sequential therapy with omeprazole and amoxicillin-clavulanate potassium at first 5 d and then omeprazole,clarithromycin and metronidazole for the late 5 d.Patients in the control group were received standard triple therapy with omeprazole,clarithromycin and amoxicillin clavulanate potassium for 10 d.After treatment for 1 month,the Hp eradication rate,treatment rate,adverse reaction were evaluated and compared by 14C urea breathe test.Result The clinical efficacy rate of observation group was 93.8 ％ （61/65）,significantly higher than that in control group （75.4％,49/65）.Meanwhile,Hp eradication rate in observation group was 90.8％ （59/65）,significantly higher than that in control group （67.7％,44/65）.The differences were significant（x2 =8.51,10.52; P ＜ 0.05）.The incidence of adverse reaction of observation group was 10.8％ （7/65）,lower than that of the control group 15.4％ （10/65）,and the differences was significant（x2 =0.61,P ＞ 0.05）.Conclusion There are high Hp eradication and relatively safe of four kinds of oral drug 10 d sequential therapy clinical in treatment of Hp infection of children.It is worthy of clinical promotion.