| 蒋明明,高刘炯.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[J].中国烧伤创疡杂志,2023,(6):492~496. |
| DOI： |
| 中文关键词: 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 |
| 英文关键词:Omeprazole Famotidine Ranitidine Triple therapy Children Peptic ulcer Helicobacter pylori |
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| 中文摘要: |
| 【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 (χ2= 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% ( χ2= 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 (χ2= 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低患儿机体炎症反应水平, 缩短腹痛时间, 提高临床疗效, 临床应用价值更高。 |
| 英文摘要: |
| 【Abstract】 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. Serum α-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 serum α-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 serum α-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 elimination 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 group and the Ranitidine group, among which there was no statistically significant difference ( χ2= 5.754, P = 0.056). After two weeks of treatment, the total effective rate of patients was 97.50% in the Omeprazole group, which was significantly higher compared with 81.08% in the Famotidine group and 72.22% in the Ranitidine group ( χ2= 9.408, P = 0.009). The incidences of adverse reactions were 5.00% , 13.51% and 22.22% respectively in the Omeprazole group, the Famotidine group and the Ranitidine group, among which there was no statistically significant difference (χ2= 4.884, P = 0.087). Conclusion Omeprazole-based, Famotidine-based and Ranitidine-based triple therapy are all effective in the treatment of Hp positive PU in children patients; however, Omeprazole-based triple therapy is more effective in reducing the degree of inflammatory response, shortening the abdominal pain elimination time and improving the clinical efficacy in such patients, presenting much high value of clinical application. |
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