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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螺杆菌 (HP)根除和疼痛缓解的疗效及不良反应。方法 采用含大剂量 (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 96 % (2 4/ 2 5 ) ,B组为 91 3 % (2 1/ 2 3) ,C组为 90 % (18/ 2 0 ) ,3组间无显著性差异 (P >0 0 5 )。A、B和C各组治疗后 3天及 1周时腹痛缓解程度与治疗前相比均有显著性差异 (P <0 0 5 ) ;但 3组之间在治疗后腹痛缓解程度均无显著性差异 (P >0 0 5 )。主要不良反应是恶心、呕吐、纳差和轻度腹泻 ,个别可有异味感。不良反应总的发生率为 19 1% ,其中A组为 2 8% ,B组为4% ,C组为 2 5 % ,B组与A组、C组间均有显著性差异 ,P <0 0 5。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 study the efficacy and side effects of triple therapy with different doses of clarithromycin in the eradication and pain relief of Helicobacter pylori (HP) in children with peptic ulcer. Methods A prospective cohort study comparing PPI triple therapy with high-dose (group A) and low-dose (group B) clarithromycin versus triple-combination PPI with amoxicillin (group C) was used. Results HP eradication rate was 96% (2 4/2 5) in group A, 91 3% (2 1/2 3) in group B and 90% (18/20) in group C, with no significant difference among the three groups (P> 0 0 5). The pain relief rates of group A, B and C at 3 days and 1 week after treatment were significantly different from those before treatment (P <0.05), but no significant difference was found between the three groups in the treatment of abdominal pain Sex differences (P> 0.05). The main adverse reactions are nausea, vomiting, anorexia and mild diarrhea, individual may have a sense of smell. The overall incidence of adverse reactions was 19.1%, of which 28% were in group A, 4% in group B, and 25% in group C, with a significant difference between group B and group A and group C, P <0 0 5. Conclusions PPI triple therapy in patients with eradication of HP, both with high rates of eradication of clarithromycin, and with low doses of clarithromycin PPI triple therapy is the best eradication program in children.