不同疗法治疗儿童幽门螺杆菌感染性消化性溃疡疗效对比  

Comparison of Clinical Efficacy of Different Therapies in the Treatment of Helicobacter Pylori Positive Peptic Ulcer in Children

作　　者：蒋明明 高刘炯 JIANG Mingming;GAO Liujiong(Department of Pediatrics,Pingyu Second People’s Hospital,Zhumadian,Henan 463400,China)

机构地区：[1]平舆县第二人民医院儿科,河南驻马店463400

出　　处：《中国烧伤创疡杂志》2023年第6期492-496,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的对比分析奥美拉唑、法莫替丁及雷尼替丁为主的三联疗法在儿童幽门螺杆菌(Hp)感染性消化性溃疡(PU)中的应用效果。方法选取2020年1月至2022年1月平舆县第二人民医院收治的113例Hp感染性PU患儿作为研究对象,采用简单随机分组法将其随机分为奥美拉唑组(40例)、法莫替丁组(37例)与雷尼替丁组(36例),奥美拉唑组患儿采用奥美拉唑三联疗法治疗,法莫替丁组患儿采用法莫替丁三联疗法治疗,雷尼替丁组患儿采用雷尼替丁三联疗法治疗,对比观察3组患儿血清α-防御素、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平以及腹痛消失时间、Hp根除情况、临床疗效与不良反应发生情况。结果治疗2周后,奥美拉唑组患儿血清α-防御素水平明显高于法莫替丁组和雷尼替丁组(q=3.607、8.032,P均<0.001),且法莫替丁组明显高于雷尼替丁组(q=4.368,P<0.001);奥美拉唑组患儿血清CRP及IL-6水平均明显低于法莫替丁组和雷尼替丁组(CRP:q=6.156、10.970,P均<0.001;IL-6:q=9.378、13.970,P均<0.001),且法莫替丁组明显低于雷尼替丁组(q=4.767、4.571,P均<0.001)。奥美拉唑组患儿腹痛消失时间明显短于法莫替丁组与雷尼替丁组(q=17.602、21.690,P均<0.001),且法莫替丁组明显短于雷尼替丁组(q=4.139,P<0.001)。奥美拉唑组患儿Hp根除率为97.50%,与法莫替丁组患儿Hp根除率83.78%及雷尼替丁组患儿Hp根除率80.56%无明显差异(χ=5.754,P=0.056)。治疗2周后,奥美拉唑组患儿总有效率为97.50%,明显高于法莫替丁组患儿总有效率81.08%及雷尼替丁组患儿总有效率72.22%(χ^(2)=9.408,P=0.009)。奥美拉唑组患儿不良反应发生率为5.00%,与法莫替丁组患儿不良反应发生率13.51%及雷尼替丁组患儿不良反应发生率22.22%无明显差异(χ^(2)=4.884,P=0.087)。结论奥美拉唑、法莫替丁及雷尼替丁三联疗法对Hp感染性PU患儿均具有一定的治疗效果,但奥美拉唑三联疗法更能有效降�Objective To compare the clinical efficacy of Omeprazole⁃,Famotidine⁃and Ranitidine⁃based triple therapy in the treatment of Helicobacter pylori(Hp)positive peptic ulcer(PU)in children patients.Methods 113 children with Hp⁃positive peptic ulcers,admitted to Pingyu Second People’s Hospital from January 2020 to January 2022,were enrolled as research subjects and divided,using the random number table,into Omeprazole group(n=40),Famotidine group(n=37)and Ranitidine group(n=36).The children in the Omeprazole group were treated with Omeprazole⁃based triple therapy;the children in the Famotidine group were treated with Famotidine⁃based triple therapy;the children in the Ranitidine group were treated with Ranitidine⁃based triple therapy.Serumα⁃defensins,C⁃reactive protein(CRP),interleukin⁃6(IL⁃6)level,the abdominal pain elimination time,Hp eradication,clinical efficacy and occurrence of adverse reactions were observed and compared among the three groups.Results After two weeks of treatment,the serumα⁃defensins level in the Omeprazole group was obviously higher than that in the Famotidine group and the Ranitidine group(q=3.607 and 8.032,both P<0.001),and serumα⁃defensins level in the Famotidine group was markedly higher than that in the Ranitidine group(q=4.368,P<0.001).The serum CRP and IL⁃6 level in the Omeprazole group were both obviously lower than those in the Famotidine group and the Ranitidine group(CRP:q=6.156 and 10.970,both P<0.001;IL⁃6:q=9.378 and 13.970,both P<0.001),and levels in the Famotidine group was markedly lower than those in the Ranitidine group(q=4.767 and 4.571,both P<0.001).The abdominal pain elimina⁃tion time in the Omeprazole group were significantly shorter than that in the Famotidine group and the Ranitidine group(q=17.602 and 21.690,both P<0.001),and the time in the Famotidine group was obviously shorter than that in the Ranitidine group(q=4.139,P<0.001).Hp eradication rates were 97.50%,83.78%and 80.56%respectively in the Omeprazole group,the Famotidine gro

关 键 词：奥美拉唑 法莫替丁 雷尼替丁 三联疗法 儿童 消化性溃疡 幽门螺杆菌 

分 类 号：R725.7[医药卫生—儿科]