两种三联疗法治疗儿童消化性溃疡的临床研究

目的比较基于质子泵抑制剂和H2受体拮抗剂的两种三联疗法治疗儿童消化性溃疡(PU)的临床疗效。方法回顾性分析2014年3月至2017年2月安徽省儿童医院收治的147例PU患儿的临床资料,按治疗方案的不同分为观察组(78例)和对照组(69例)。观察组采用奥美拉唑+克拉霉素片+阿莫西林治疗,对照组采用雷尼替丁+克拉霉素片+阿莫西林治疗。对两组患儿的临床疗效、幽门螺杆菌根除率、细胞因子水平变化情况及不良反应发生情况进行统计分析。结果(1)观察组的治疗总有效率和治愈率分别为96.15%、73.08%,显著高于对照组的78.26%、50.72%(χ^2值分别为10.913、7.816,均P<0.01)。(2)观察组的幽门螺杆菌根除率为93.59%(73/78),高于对照组的73.91%(51/69),两组差异有统计学意义(χ^2=10.744,P=0.001)。(3)治疗后,观察组血清白介素(IL)-2、IL-6两项指标的改善程度均较对照组更明显(t值分别为7.750、-2.853,均P<0.05)。(4)两组患儿治疗期间均未出现严重不良反应,不良反应总发生率差异无统计学意义(χ^2=0.625,P>0.05)。结论基于质子泵抑制剂的三联疗法较基于H2受体拮抗剂的三联疗法治疗儿童PU的临床疗效更为理想。

Clinical study of two triple therapy for children with peptic ulcer

Objective To compare the efficacy of two triple therapy regimens based on proton pump inhibitors and H2 receptor antagonists in the treatment of children with peptic ulcer(PU).Methods Clinical data of 147 children with PU and admitted to Anhui Children’s Hospital from March 2014 to February 2017 were retrospectively collected.All of them were divided into control group(69 cases)and observation group(78 cases)according to different treatment plan.The observation group was treated with omeprazole,amoxicillin and clarithromycin tablets,while the control group using ranitidine,clarithromycin Tablets and amoxicillin treatment.Finally,clinical efficacy,the eradication rate of Helicobacter pylori(Hp),the change of cytokine levels and the occurrence of adverse reactions in the two groups were statistically analyzed.Results(1)The total efficiency and healing rate of the observation group were 96.15%and 73.08%,which were significantly higher than those of the control group(χ^2=10.913 and 7.816,respectively,both P<0.01).(2)The eradication rate of Hp of observation group was 93.59%(73/78),which was significantly higher than that of the control group[73.91%(51/69)](χ^2=10.744,P=0.001).(3)After treatment,the improvement degrees of serum interleukin-2(IL-2)and IL-6 in observation group were more significant than those in the control group(t=3.391 and 4.639,respectively,both P<0.05).(4)There was no serious adverse reaction during the treatment of the two groups of children,and the total incidence rate of adverse reaction of two groups was not statistically significant(χ^2=0.625,P>0.05).Conclusion Triple therapy based on proton pump inhibitors is more effective than triple therapy based on H2 receptor antagonist in the treatment of PU in children.