不同治疗方案对儿童幽门螺杆菌感染的临床疗效评价

Clinical effects of different therapeutic regimens for Helicobacter pylori infection in children

目的评价4种幽门螺杆菌(H.pylori)感染根除方案:序贯疗法、三联疗法、序贯合用乳酸菌及三联合用乳酸菌疗法的疗效。方法 416例H.pylori感染患者随机分为4组:序贯疗法(102例)、三联疗法(100例)、序贯合用乳酸菌(109例)及三联合用乳酸菌(105例)组。分析4组患儿的临床疗效、H.pylori根除率、成本/效果比值及不良反应发生率等。结果 4组治疗方案的疗效以序贯合用乳酸菌或三联合用乳酸菌组的疗效较好(P<0.05)。4种治疗方案显效率及H.pylori根除率均以序贯合用乳酸菌组最高,其次为三联合用乳酸菌组,三联疗法组最低(P<0.05)。4组患儿的成本/效果比值以序贯疗法组最低、序贯合用乳酸菌组次低,三联合用乳酸菌组最高(P<0.01)。不良反应发生率最低的是序贯合用乳酸菌组,次低为三联合用乳酸菌组,最高的为三联疗法组。结论序贯合用乳酸菌疗法为最佳儿童幽门螺杆菌感染根除治疗方案。

Objective To investigate the clinical effects of sequential therapy, triple therapy, sequential therapy combined with Lactobacillus, and triple therapy combined with Lactobacillus in the eradication of Helicobacter pylori （H.pylori） infection in children. Methods A total of 416 children with H.pylori infection were randomly assigned to sequential group （102 children）, triple group （100 children）, sequential-Lactobacillus group （109 children）, and triple- Lactobacillus group （105 children）. The clinical outcome, H.pylori eradication rate, cost-effect ratio, and incidence of adverse events were compared between the four groups. Results The sequential-Lactobacillus and triple- Lactobacillus groups had significantly better clinical outcomes than the sequential group and the triple group （P〈0.05）. The sequential-Lactobacillus group had the highest marked response rate, followed by the triple-Lactobacillus group. The triple group had the lowest marked response rate. The sequential-Lactobacillus group also had the highest H.pylori eradication rate, followed by the triple-Lactobacillus group. The triple group had the lowest H.pylori eradication rate （P〈0.05）. The sequential group had the lowest cost-effect ratio, followed by the sequential-Lactobacillus group. The triple group had the highest cost-effect ratio （P〈0.01）. The sequential-Lactobacillus group had the lowest incidence rate of adverse events, followed by the triple-Lactobacillus group. The triple group had the highest incidence rate. Conclusions Sequential therapy combined with Lactobacillus seems to be the best regimen for the eradication ofH.pylori infection in children.