Kawakami Elisabete, Machado Rodrigo Strehl, Ogata Silvio Kazuo, Langner Marini, Fukushima Erika, Carelli Anna Paula, Bonucci Vania Cláudia Guimarães, Patricio Francy Reis Silva
Peptic Diseases Outpatient Clinic, Pediatric Gastroenterology Division, Universidade Federal do São Paulo/Escola Paulista de Medicina, São Paulo SP, Brazil.
World J Gastroenterol. 2006 Sep 14;12(34):5544-9. doi: 10.3748/wjg.v12.i34.5544.
To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis.
A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive (13)C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone (100 mg, 200 mg if over 30 kg) twice daily. Eradication of H pylori was assessed two months after treatment by histology and (13)C -urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment.
Thirty-eight patients (24 females, 14 males) were included. Their age ranged from 4 to 17.8 (mean 10.9 +/- 3.7) years. On intent-to-treat analysis (n = 38), the eradication rate of H pylori was 73.7% (95% CI, 65.2%-82%) whereas in per-protocol analysis (n = 33) it was 84.8% (95% CI, 78.5%-91%). All the patients with duodenal ulcer (n = 7) were successfully treated (100% vs 56.2% with antral nodularity). Side effects were reported in 26 patients (68.4%), mainly vomiting (14/26) and abdominal pain (n = 13). Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of H pylori-positive patients after six months of treatment.
Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.
评估以呋喃唑酮为基础的三联疗法治疗有症状的儿童幽门螺杆菌胃炎的效果。
开展一项前瞻性连续开放试验。该研究纳入了38例有足够严重的上消化道症状而需进行内镜检查的患者。幽门螺杆菌状态根据组织学检查和阳性（13）C尿素呼气试验来确定。药物治疗方案为奥美拉唑、克拉霉素和呋喃唑酮（100毫克，30公斤以上者为200毫克）疗程7天，每日2次。治疗两个月后通过组织学检查和（13）C尿素呼气试验评估幽门螺杆菌的根除情况。治疗后7天、2个月和6个月进行进一步的临床评估。
纳入38例患者（24例女性，14例男性）。年龄范围为4至17.8岁（平均10.9±3.7岁）。在意向性分析（n = 38）中，幽门螺杆菌根除率为73.7%（95%CI，65.2%-82%），而在符合方案分析（n = 33）中为84.8%（95%CI，78.5%-91%）。所有十二指肠溃疡患者（n = 7）均成功治愈（100%，而胃窦结节患者为56.2%）。26例患者（68.4%）报告有副作用，主要为呕吐（14/26）和腹痛（n = 13）。成功治疗的消化不良患者中，幽门螺杆菌阴性患者在治疗6个月后78.9%有改善，幽门螺杆菌阳性患者在治疗6个月后50%有改善。
呋喃唑酮三联疗法在幽门螺杆菌治疗中取得中等疗效。十二指肠溃疡患者的根除率似乎更高。
