10天序贯疗法对儿童幽门螺杆菌感染的疗效观察

目的评估序贯疗法和标准三联疗法对儿童幽门螺杆菌感染根除率的影响。方法将湖北省妇幼保健院120例幽门螺杆菌感染儿童随机分为两组。序贯治疗组60例,给予奥美拉唑和阿莫西林.克拉维酸钾治疗5 d,继以奥美拉唑、克拉霉素和替硝唑治疗5 d。标准三联治疗组60例,给予奥美拉唑、阿莫西林.克拉维酸钾和克拉霉素治疗10d。停药4周后进行尿素酶呼气试验,判断根除效果,计算幽门螺杆菌的根除率。结果 120例纳入者均完成治疗及随访,两组儿童幽门螺杆菌的根除率分别为91.7%（55/60）和86.7%（52/60）,差异没有统计学意义（P〉0.05）,不良反应发生率组间比较差异无统计学意义（P〉0.05）,均能耐受治疗。结论序贯治疗及标准三联治疗均能获得较高的幽门螺杆菌根除率,无明显不良反应,但10天序贯疗法更为理想。

Effects of Sequential Therapy for Helicobacter Pylori Eradication in Children

Objective To compare the effectiveness of standard triple therapy and a new sequential therapy for Helicobacter pylori eradication in children.Methods A total of 120 Helicobacter pylori positive children were enrolled in the study and randomly allocated into two groups.The first group（n=60） received the sequential therapy（omeprazole＋amoxicillin and clavulanate potassium for the first 5 days and followed by omeprazole＋tinidazole＋clarithromycin for the remaining 5 days）;the second group（n=60） received a standard 10-day triple therapy（omeprazole＋amoxicillin and clavulanate potassium＋clarithromycin）.Eradication rates were determined 4 weeks after the treatment by urea breath test.Eradication rates were calculated.Results The eradication rate was 91.7%（55/60） in children with sequential therapy,but not achieve the statistic significant comparing with 10-day standard triple therapy（86.7%,52/60）,P0.05.The two treatment protocols were generally well tolerated.Conclusion Sequential therapy is effective for eradicating Helicobacter pylori but do not achieve statistically significant compared with 10-day standard triple therapy.