Effect of omeprazole combined with probiotics on Helicobacter pylori-positive chronic gastritis in children and its influence on inflammatory response and gastrointestinal function
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摘要: 目的 研究奥美拉唑联合益生菌对小儿幽门螺杆菌阳性慢性胃炎的疗效及对炎症反应和胃肠道功能的影响。方法 选取2020年5月—2022年5月收治的幽门螺杆菌阳性慢性胃炎患儿120例，按照随机数字表法分为对照组(n=60)和研究组(n=60)。对照组给予克拉霉素+阿莫西林+奥美拉唑治疗，研究组在对照组基础上给予益生菌治疗。比较治疗前后2组的炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、胃肠道功能[胃肠道功能症状评定量表(GSRS)]、胃蛋白酶原比值(PGR)、胃蛋白酶原Ⅰ(PGⅠ)及胃泌素17(G-17)水平，并比较治疗后2组的临床疗效(总有效率)、幽门螺杆菌根治率及治疗后3个月的复发率，同时统计2组不良反应发生率。结果 治疗后，研究组总有效率、幽门螺杆菌根治率均显著高于对照组，复发率、TNF-α、IL-6及CRP水平、GSRS评分、PGR、PGⅠ及G-17水平均显著低于对照组(P<0.05)，2组不良反应发生率差异无统计学意义(P>0.05)。结论 奥美拉唑联合益生菌治疗幽门螺杆菌阳性慢性胃炎可改善患儿临床症状，降低炎症反应及调节黏膜分泌，恢复胃肠道功能，安全有效。Abstract: Objective To study the effect of omeprazole combined with probiotics on Helicobacter pylori-positive chronic gastritis in children and its influence on inflammatory response and gastrointestinal function.Methods A total of 120 children with Helicobacter pylori-positive chronic gastritis admitted to our hospital from May 2020 to May 2022 were selected and divided into a control group(n=60) and a study group(n=60) according to the random number table method. The control group was treated with clarithromycin+amoxicillin+omeprazole, and the study group was treated with probiotics based on the control group. The levels of inflammatory factors[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), C-reactive protein(CRP)], gastrointestinal function[gastrointestinal symptom rating scale(GSRS)], pepsinogen ratio(PGR), pepsinogen Ⅰ(PGI), and gastrin 17(G-17) were compared between the two groups before and after treatment. The clinical efficacy(total effective rate), eradication rate of Helicobacter pylori, and recurrence rate 3 months after treatment were compared between the two groups, and the incidence of adverse reactions was statistically analyzed.Results After treatment, the total effective rate and Helicobacter pylori eradication rate in the study group were significantly higher than those in the control group, and the recurrence rate, TNF-α, IL-6, and CRP levels, GSRS score, PGR, PGI, and G-17 levels were significantly lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Omeprazole combined with probiotics in the treatment of Helicobacter pylori-positive chronic gastritis in children can improve clinical symptoms, reduce the inflammatory response, regulate mucosal secretion, and restore gastrointestinal function, which is safe and effective.
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Key words:
- chronic gastritis /
- Helicobacter pylori /
- probiotics /
- omeprazole /
- inflammatory response /
- gastrointestinal function
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表 1 2组临床疗效比较
例(%) 组别 例数 治愈 显效 有效 无效 总有效 对照组 60 16(26.67) 20(33.33) 14(23.33) 10(16.67) 50(83.33) 研究组 60 25(41.67) 17(28.33) 16(26.67) 2(3.33) 58(96.67) χ2 5.926 P 0.015 
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表 2 2组炎性因子水平比较
X±S 组别 例数 TNF-α/(pg/mL) IL-6/(pg/mL) CRP/(mg/L) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 60 58.26±9.62 36.92±6.451) 42.99±7.26 25.23±4.861) 25.27±4.63 14.83±2.421) 研究组 60 59.27±9.29 23.43±4.161) 43.07±7.34 15.24±2.281) 26.24±4.11 8.17±1.731) t 0.585 13.614 0.060 14.415 1.214 17.342 P 0.560 < 0.001 0.952 < 0.001 0.227 < 0.001 与本组治疗前比较，1)P<0.05。
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表 3 2组GSRS评分比较
分，X±S 组别 例数 治疗前 治疗后 对照组 60 74.53±8.64 39.55±5.261) 研究组 60 75.65±8.33 25.36±4.741) t 0.723 15.523 P 0.471 < 0.001 与本组治疗前比较，1)P<0.05。
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表 4 2组PGR、PGⅠ及G-17水平比较
X±S 组别 例数 PGR PGⅠ/(μg/L) G-17/(pmol/L) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 60 7.86±1.54 6.46±1.221) 126.67±25.37 115.74±18.371) 7.46±1.58 6.45±0.861) 研究组 60 7.91±1.62 5.31±0.851) 127.11±26.16 102.28±16.631) 7.51±1.66 5.13±0.481) t 0.173 5.991 0.094 4.208 0.169 10.382 P 0.863 < 0.001 0.926 < 0.001 0.866 < 0.001 与本组治疗前比较，1)P<0.05。
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