目的 探討奧美拉唑三聯(lián)療法治療小兒消化性潰瘍的臨床療效。方法 選擇2020年1月—2021年1月在新鄭市中醫(yī)院就診治療的90例消化性潰瘍患兒，按照入院先后順序?qū)⑺谢純悍譃閷?duì)照組和治療組，每組各45例。對(duì)照組采用雷尼替丁三聯(lián)療法進(jìn)行治療：口服鹽酸雷尼替丁膠囊，3~5 mg/（kg·d），2次/d；口服克拉霉素緩釋片，15~20 mg/（kg·d），2次/d；口服阿莫西林膠囊，30~50 mg/（kg·d），2次/d。治療組采用奧美拉唑三聯(lián)療法進(jìn)行治療：口服奧美拉唑腸溶膠囊，0.6~0.8 mg/（kg·d），1次/d；克拉霉素緩釋片、阿莫西林膠囊用法用量均與對(duì)照組相同。兩組患兒治療6周。觀察兩組患兒的臨床療效，比較兩組患兒治療前后的炎性因子水平、胃腸道激素水平。結(jié)果 治療后，治療組患兒的總有效率（93.33%）高于對(duì)照組（77.78%），組間比較有顯著差異（P<0.05）。治療后，兩組患兒血清白細(xì)胞介素-25（IL-25）、C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）水平均明顯降低，有統(tǒng)計(jì)學(xué)差異（P<0.05）；治療后治療組患兒血清IL-25、CRP、TNF-α水平均低于對(duì)照組，組間比較有顯著差異（P<0.05）。治療后，兩組患兒血清胃動(dòng)素（MTL）、胃泌素（GAS）水平均明顯降低，生長(zhǎng)抑素（SS）水平明顯升高，有統(tǒng)計(jì)學(xué)差異（P<0.05）；治療后治療組患兒血清MTL、GAS水平低于對(duì)照組，SS水平高于對(duì)照組，組間比較差異有顯著差異（P<0.05）。治療后，治療組患兒的幽門螺桿菌根除率為91.11%，高于對(duì)照組的幽門螺桿菌根除率77.77%；治療組患兒潰瘍愈合率為80.00%，高于對(duì)照組的潰瘍愈合率62.22%，組間比有顯著差異（P<0.05）。結(jié)論 奧美拉唑腸溶膠囊三聯(lián)療法治療患兒消化性潰瘍具有較好的臨床效果，可減輕患兒的炎性反應(yīng)、調(diào)節(jié)胃腸道激素，安全性較高，值得臨床上借鑒。

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

國(guó)家自然科學(xué)基金資助項(xiàng)目（81303096）