不同一线疗法根除儿童幽门螺杆菌的疗效观察

Comparison between different first-line therapy protocols of eradicating Helicobacter pylori in children

目的本研究通过对比不同一线疗法对辽宁地区儿童幽门螺杆菌(Helicobacterpylori,Hp)感染的疗效,探讨更加优化的儿童Hp根除方案。方法选取2016年10月至2017年9月中国医科大学附属盛京医院小儿消化内科门诊与住院进行胃镜检查诊断为消化性溃疡或慢性胃炎的124例确诊Hp感染的患儿为研究对象,随机分为4组,标准三联疗法治疗10d组(A组)、标准三联疗法治疗14d组(B组)、含铋剂三联疗法组(C组)、序贯疗法组(D组),比较4组Hp根除率以及各组不良反应发生率。结果在根除率方面,A(56.7%)、B(51.6%)、C(58.6%)三组间无明显差异(P>0.05),而D组根除率(90.0%)显著高于其他3组,差异有统计学意义(P<0.05)。治疗期间不良反应主要表现为腹痛、饱胀、恶心呕吐、食欲差等;总不良反应发生率A(6.7%)、B(9.7%)、D(10.0%)三组间无明显差异(P>0.05),而C组(41.4%)高于其他3组,差异有统计学意义(P<0.05)。结论序贯疗法在Hp根除率方面明显高于传统三联疗法及含铋剂三联疗法。而不良反应发生率方面,含铋剂三联疗法不良反应发生率最高。

Objective To determine the efficacy of different first-line regimens for Helicobacter pylori(Hp) eradication, and to suggest an alternative first-line therapy particularly in children. Methods One hundred and twenty-four patients who diagnosed as peptic ulcer or chronic gastritis by gastroscope with Hp infection were included and randomly divided into four groups, each receiving different first-line eradication therapy.A group: standard triple therapy for 10 days;B group: standard triple therapy for 14 days;C group: triple therapy containing bismuth agent;D group: sequential therapy.The eradication rates of Hp and adverse event rates in four groups were compared. Results The highest eradication rate was in D group (90.9%, P<0.05), there was no significant difference between the other three groups (P>0.05). The main adverse reactions during treatment were abdominal pain, fullness, nausea and vomiting.Among them, adverse event rate was the highest in C group (41.4%, P<0.05), there was no significant difference between the other three groups (P>0.05). Conclusion The sequential therapy is significantly more effective than standard triple therapy and triple therapy containing bismuth agent.Adverse event rate is the highest in the triple therapy containing bismuth agent.