Zhao Hong-Mei, Ou-Yang Hong-Juan, Duan Bo-Ping, Xu Bin, Chen Zhi-Yong, Tang Juan, You Jie-Yu
Department of Gastroenterology, Hunan Children's Hospital, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Mar;16(3):230-3.
To evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori (Hp) infection among children in terms of Hp eradication rate and incidence of adverse events.
A prospective randomised controlled study was conducted on 240 children with a confirmed diagnosis of Hp infection. These patients were randomized into triple therapy (n=120) and probiotics groups (n=120). The triple therapy group received amoxicillin [40 mg/(kg·d), Tid], clarithromycin [15 mg/(kg·d), Bid] and omeprazole [0.7-0.8 mg/(kg·d), Qd], while the probiotics group received Saccharomyces boulardii (250 mg, Bid) in addition to triple therapy. The course of treatment was 14 days in both groups. The adverse events in subjects were recorded by their parents during treatment. Hp eradiation was evaluated by (13)C breath test at 4 weeks after treatment, and the eradication rate and incidence of adverse events were compared between the two groups.
The Hp eradication rates were 75.8% (91/120) in the triple therapy group and 85% (102/120) in the probiotics group (P>0.05). Compared with the triple therapy group, the probiotics group had nonsignificantly lower incidence of nausea, vomiting, and abdominal pain (P>0.05) and significantly lower incidence of stomatitis, constipation and diarrhea (P<0.05).
Triple therapy combined with Saccharomyces boulardii cannot significantly increase Hp eradication rate, but can significantly reduce the incidence of stomatitis, constipation, and diarrhea during treatment.
从幽门螺杆菌(Hp)根除率和不良事件发生率方面,评估以质子泵抑制剂为基础的三联疗法联合布拉氏酵母菌治疗儿童Hp感染的临床效果。
对240例确诊为Hp感染的儿童进行前瞻性随机对照研究。这些患者被随机分为三联疗法组(n = 120)和益生菌组(n = 120)。三联疗法组接受阿莫西林[40mg/(kg·d),每日3次]、克拉霉素[15mg/(kg·d),每日2次]和奥美拉唑[0.7 - 0.8mg/(kg·d),每日1次],而益生菌组在三联疗法基础上额外接受布拉氏酵母菌(250mg,每日2次)。两组治疗疗程均为14天。治疗期间由患儿家长记录受试者的不良事件。治疗后4周通过(13)C呼气试验评估Hp根除情况,并比较两组的根除率和不良事件发生率。
三联疗法组的Hp根除率为75.8%(91/120),益生菌组为85%(102/120)(P>0.05)。与三联疗法组相比,益生菌组恶心、呕吐和腹痛的发生率无显著降低(P>0.05),但口腔炎、便秘和腹泻的发生率显著降低(P<0.05)。
三联疗法联合布拉氏酵母菌不能显著提高Hp根除率,但可显著降低治疗期间口腔炎、便秘和腹泻的发生率。