Ashorn Merja, Rägö Tiina, Kokkonen Jorma, Ruuska Tarja, Rautelin Hilpi, Karikoski Riitta
Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
J Clin Gastroenterol. 2004 Sep;38(8):646-50. doi: 10.1097/01.mcg.0000135366.58536.b3.
Controlled trials considering the effect of Helicobacter pylori (H. pylori) eradication on gastrointestinal symptoms in children are scant. We aimed to study the connection between recurrent abdominal pain and dyspepsia and H. pylori infection in children.
This was a double blind randomised controlled trial. Twenty children with recurrent abdominal pain (RAP) being H. pylori positive as measured with the C urea breath test (UBT) were randomized either to receive omeprazole, amoxycillin and clarithromycin (n = 10), or omeprazole and 2 placebos (n = 10) for 1 week after gastroscopy. Symptoms were registered prior to the treatment and at follow up visits 2, 6, 24, and 52 weeks after stopping the treatment. Control UBT was performed on all patients 6 weeks post-treatment and again at the 52 week follow-up visit, when also re-endoscopy with biopsies was done to all participants.
All infected children had histologic gastritis. Bacterial eradication was achieved in 8/10 in the triple treatment group and in none in the placebo group. There was no change in symptom index in either group at 2 weeks post treatment. At 52 weeks a similar reduction in symptom index was observed in both groups irrespective of the healing of gastritis, which was more commonly achieved along the eradication.
Bacterial eradication and healing of gastric inflammation does not lead to symptomatic relief of chronic abdominal pain in children.
关于幽门螺杆菌（H. pylori）根除对儿童胃肠道症状影响的对照试验很少。我们旨在研究儿童反复腹痛、消化不良与H. pylori感染之间的联系。
这是一项双盲随机对照试验。20名经C尿素呼气试验（UBT）检测为H. pylori阳性的反复腹痛（RAP）儿童，在胃镜检查后随机分为两组，一组接受奥美拉唑、阿莫西林和克拉霉素治疗（n = 10），另一组接受奥美拉唑和两种安慰剂治疗（n = 10），疗程均为1周。在治疗前以及停止治疗后2周、6周、24周和52周的随访中记录症状。所有患者在治疗后6周进行对照UBT检测，在52周随访时再次进行检测，此时所有参与者均再次接受内镜检查并取活检。
所有感染儿童均有组织学胃炎。三联治疗组10例中有8例实现细菌根除，安慰剂组无1例根除。治疗后2周两组症状指数均无变化。在52周时，两组症状指数均有类似程度下降，无论胃炎是否愈合，胃炎愈合在根除治疗中更常见。
根除细菌和治愈胃炎症并不能缓解儿童慢性腹痛的症状。
