摘要
目的 用克拉霉素 (CLA)与胶体次枸橼酸铋 (CBS)联合应用 ,加另一种抗生素 ,治疗儿童Hp相关性胃炎 ,以评价不同治疗方案的疗效和观察根除Hp感染与胃炎好转的关系。方法 2 76例 4～ 14岁患儿经胃镜检查确诊为幽门螺杆菌 (Hp)相关性胃十二指肠疾病 ,随机分为A、B、C、D四组 ,接受以CBS为主的三联疗法。A、C、D组用克拉霉素 (CLA) 15mg/ (kg·d)联合CBS 9mg/ (kg·d) ,再加另一种抗生素 ,[A组羟氨苄青霉素 (阿莫西林 ) (AMO) 4 0mg/ (kg·d) ,C组甲硝唑 (Met)18mg/ (kg·d) ,D组呋喃唑酮 (FUR) 4mg/ (kg·d) ],治疗 1周。B组是标准三联疗法 (CBS +AMO +Met,剂量同上 ) ,治疗 2周。服药前及停用抗Hp治疗后 4周以上作胃镜检查及Hp检测 ,或停药 4周以上做13 碳 (13 C)尿素呼气试验。全部病例完成治疗和复查。结果 (1)治疗后Hp根治率A组 5 4%(2 1/ 39) ,B组 81% (47/ 5 8) ,C组 93% (42 / 45 ) ,D组 91% (12 2 / 134 )。C、D二组根除率均高于B组根除率的 10 %以上。四个方案组对Hp根除率疗效差异有非常显著性 ,χ2 =34 .730 ,P <0 .0 1。 (2 )各组与标准方案B组比较 ,A方案较B方案差 ,C、D方案Hp根除率高于B方案 ,其中人数较多的D方案差异具有显著性 (χ2 =3.847,P <0 .0 5 )。 (3)A、C、D三组治疗后 3d内?
Objective To evaluate the therapeutic effect of different programs consisted of clarithromycin (CLA), colloidal bismuth subsitrate (CBS) plus another antibacterial agent by comparing to standard triple therapy on Helicobacter pylori (Hp) related gastritis in children. Methods Two hundred and seventy six children (4 to 14 years old) with gastroscopically confirmed Hp related gastroduodenal disease were divided into 4 groups (A, B, C and D) at random. These children were given 4 different triple therapies with each of which contained CBS. Groups A, C and D were given CBS, 4.5 mg/kg bid; CLA 7.5 mg/kg bid as a second drug, plus another antibacterial agent, i.e., amoxicillin (AMO), 20 mg/kg bid for group A, metronidazole (Met), 9 mg/kg bid group C and: furazolidone (FUR), 2 mg/kg bid for group D, for one week. Group B was given a standard triple therapy (CBS+AMO+Met, the same dosage as mentioned above) for two weeks. Gastroscopy was performed in these patients prior to medication and over 4 weeks after therapy and Hp infection was detected by culture and histology or by 13 C urea breath test ( 13 C UBT) over 4 weeks after the therapy. All the patients completed the whole study.Results (1) The eradication rates of Hp were as follows: group A: 54 % (21/39); group B: 81 % (47/58); group C: 93 % (42/45) and group D: 91 % (122/134). The eradication rates of group C and D were about 10 % higher than group B. The differences were highly significant (χ 2=34.730, P <0.001). (2) The comparison among the 4 groups showed that group A had poorest effect, while group D had the highest eradication rate (χ 2=3.847, P <0.05). (3) Within 3 days, 1 and 2 weeks after therapy, the pain relief rates in groups A, C, and D were 75 %, 90 % and 95 %, respectively. (4) The side effects in the 4 groups (nausea, vomiting, diarrhea and a few rashes) were mild. Their occurrence rate was the lowest in group A (5 %) followed by group C (7 %) and group D (8 %); the highest (9 %) was seen in group B. The symptoms caused by the side effects disappeared when the medication was completed. Conclusion Satisfactory effect was achieved in treatment of Hp related gastrodudenal disease after the eradication of Hp in the children studied. Low dose triple therapy with CBS, CLA and Met or FUR for a week was highly effective and well tolerated in treatment of Hp related gastritis in children. The side effects were minor. The symptoms of gastritis were well relieved. Therefore, the triple therapy composed of CBS, CLA and Met seemed to be of great value and worthy of clinical application.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第4期213-216,共4页
Chinese Journal of Pediatrics
关键词
幽门螺杆菌
儿童
药物疗法
克拉霉素
CBS
Helicobacter pylori
Gastritis
Child
Duodenal
Bismuth
Clarithromycin
