目的 探讨奥美拉唑三联疗法治疗小儿消化性溃疡的临床疗效。方法 选择2020年1月—2021年1月在新郑市中医院就诊治疗的90例消化性溃疡患儿，按照入院先后顺序将所有患儿分为对照组和治疗组，每组各45例。对照组采用雷尼替丁三联疗法进行治疗：口服盐酸雷尼替丁胶囊，3~5 mg/（kg·d），2次/d；口服克拉霉素缓释片，15~20 mg/（kg·d），2次/d；口服阿莫西林胶囊，30~50 mg/（kg·d），2次/d。治疗组采用奥美拉唑三联疗法进行治疗：口服奥美拉唑肠溶胶囊，0.6~0.8 mg/（kg·d），1次/d；克拉霉素缓释片、阿莫西林胶囊用法用量均与对照组相同。两组患儿治疗6周。观察两组患儿的临床疗效，比较两组患儿治疗前后的炎性因子水平、胃肠道激素水平。结果 治疗后，治疗组患儿的总有效率（93.33%）高于对照组（77.78%），组间比较有显著差异（P<0.05）。治疗后，两组患儿血清白细胞介素-25（IL-25）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平均明显降低，有统计学差异（P<0.05）；治疗后治疗组患儿血清IL-25、CRP、TNF-α水平均低于对照组，组间比较有显著差异（P<0.05）。治疗后，两组患儿血清胃动素（MTL）、胃泌素（GAS）水平均明显降低，生长抑素（SS）水平明显升高，有统计学差异（P<0.05）；治疗后治疗组患儿血清MTL、GAS水平低于对照组，SS水平高于对照组，组间比较差异有显著差异（P<0.05）。治疗后，治疗组患儿的幽门螺杆菌根除率为91.11%，高于对照组的幽门螺杆菌根除率77.77%；治疗组患儿溃疡愈合率为80.00%，高于对照组的溃疡愈合率62.22%，组间比有显著差异（P<0.05）。结论 奥美拉唑肠溶胶囊三联疗法治疗患儿消化性溃疡具有较好的临床效果，可减轻患儿的炎性反应、调节胃肠道激素，安全性较高，值得临床上借鉴。

Objective To investigate the clinical efficacy of omeprazole-based triple therapy in treatment of peptic ulcer in children. Methods Children (90 cases) with peptic ulcer in Xinzheng Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were divided into control and treatment groups according to the order of admission, and each group had 45 cases. Patients in the control group were treated with ranitidine-based triple therapy:patients in the control group were po administered with Ranitidine Hydrochloride Capsules, 3-5 mg/(kg·d), twice daily; and also po administered with Clarithromycin Sustained Release Tablets, 15-20 mg/(kg·d), twice daily; and also po administered with Amoxicillin Capsules, 30-50 mg/(kg·d), twice daily. Patients in the treatment group were treated with omeprazole -based triple therapy:patients in the treatment group were po administered with Omeprazole Enteric Capsules, 0.6-0.8 mg/(kg·d), once daily; and the usage and dosage of clarithromycin and amoxicillin were the same as those in the control group. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacies were evaluated, and the levels of inflammatory factors and gastrointestinal hormones in two groups were compared.Results After treatment, the total effective rate of children in the treatment group (93.33%) was higher than that in the control group (77.77%), there was a difference between two groups (P < 0.05). After treatment, the levels of IL-25, CRP, and TNF-α in two groups were significantly decreased, and there were statistical differences (P < 0.05). After treatment, the levels of IL-25, CRP, and TNF-α in the treatment group were lower than those in the control group, and there was a difference between two groups (P < 0.05). After treatment, the levels of MTL and GAS in two groups were significantly decreased, but the SS level were significantly increased, and there were statistical differences (P < 0.05). After treatment, the MTL and GAS of the treatment group were lower than those of the control group, but the SS level was higher than that of the control group, and there were significant difference between the two groups (P < 0.05). After treatment, the eradication rate of Helicobacter pylori in the treatment group was 91.11%, which was higher than 77.77% in the control group. The ulcer healing rate in the treatment group was 80.00%, which was higher than 62.22% in the control group (P < 0.05). Conclusion Omeprazole Enteric Capsules -based triple therapy has clinical effect in treatment of peptic ulcer in children, can reduce the inflammatory reaction of children, and regulate gastrointestinal hormones of children, with good safety, which is worthy of clinical reference.

R975;R985

国家自然科学基金资助项目（81303096）