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目的比较10d序贯疗法(包括雷贝拉唑、阿莫西林克拉维酸钾干混悬剂、克拉霉素)和7d传统三联疗法(包括奥美拉唑、阿莫西林、克拉霉素)治疗儿童幽门螺杆菌(Hp)阳性胃病的疗效和安全性。方法将2006年10月至2009年8月洛阳市机车医院123例Hp阳性胃病患儿随机分为两组,对照组(41例)进行7d传统三联疗法,治疗组(82例)给予10d序贯疗法。疗程结束7～10d后检查消化性溃疡愈合情况和Hp清除率,评估症状积分和副反应。结果溃疡愈合率对照组为40%,治疗组为55.5%,差异有统计学意义(P<0.05)。Hp清除率治疗组为92.68%,对照组为70.73%,差异有统计学意义(P<0.05),治疗组症状总积分治疗前为(56.89±4.32)分,治疗后为(14.96±2.13)分;对照组症状总积分治疗前为(58.75±5.12)分,治疗后为(21.42±3.78)分,两组症状总积分治疗后较治疗前均有显著下降(P<0.05或P<0.01),治疗组变化更为明显(P<0.01)。治疗组副反应低于对照组(6.1%对17.1%,P>0.05)。结论包括雷贝拉唑、阿莫西林克拉维酸钾干混悬剂及克拉霉素的10d序贯疗法治疗儿童Hp阳性胃病比7d传统三联疗法更有效。
Objectives To compare the efficacy and safety of 10d sequential therapy (including rabeprazole, amoxicillin and clavulanate potassium clavulanate, and clarithromycin) and 7d conventional triple therapy (including omeprazole, amoxicillin and clarithromycin) Efficacy and safety of Helicobacter pylori (Hp) positive stomach in children. Methods A total of 123 Hp-positive cases of gastropathy from October 2006 to August 2009 in Luoyang Locomotive Hospital were randomly divided into two groups. The control group (41 cases) received conventional triple therapy for 7 days. The treatment group (82 cases) therapy. Seven to 10 days after the end of treatment, peptic ulcer healing and Hp clearance were examined to assess symptom scores and side effects. Results The healing rate of ulcer was 40% in the control group and 55.5% in the treatment group, the difference was statistically significant (P <0.05). Hp clearance rate was 92.68% in the treatment group and 70.73% in the control group, with a significant difference (P <0.05). The total score of the treatment group was (56.89 ± 4.32) before treatment and (14.96 ± 2.13) after the treatment (58.75 ± 5.12) points before treatment and (21.42 ± 3.78) points after treatment respectively. The total scores of symptoms in both groups were significantly lower than those before treatment (P <0.05 or P <0.01) The treatment group changed more obviously (P <0.01). Side effects in the treatment group were lower than those in the control group (6.1% vs 17.1%, P> 0.05). Conclusions 10-day sequential therapy including rabeprazole, amoxicillin and clavulanate dry suspension, and clarithromycin is more effective than conventional triple therapy in children with Hp-positive stomach disease.