不同剂量甲泼尼龙联合抑酸剂在儿童腹型过敏性紫癜中的疗效与安全性评价

发布时间：2019-04-03 13:31

【摘要】：目的:通过对比分析不同剂量甲泼尼龙联合不同抑酸剂的疗效及安全性,寻求治疗儿童腹型过敏性紫癜的最佳治疗方案。方法:选择符合本研究的腹型过敏性紫癜患儿300例,将其随机分为6组(n=50):A组(小剂量甲泼尼龙联合西咪替丁)、B组(小剂量甲泼尼龙联合奥美拉唑)、C组(中剂量甲泼尼龙联合西咪替丁)、D组(中剂量甲泼尼龙联合奥美拉唑)、E组(大剂量甲泼尼龙联合西咪替丁)、F组(大剂量甲泼尼龙联合奥美拉唑)。各组数据采用多因素统计方法对比观察各组疗效及安全性。结果:(1)1d缓解率:F组的1天缓解率高于A、B、C组,差异有统计学意义(P"fα′),但尚不能认为其余各组间的1天缓解率差异有统计学意义(Pα′)。(2)3d缓解率D、E、F组的3天缓解率均高于A组,差异有统计学意义(P"fα′)。F组的3天缓解率高于A、B、C组,差异有统计学意义(P"fα′)。但尚不能认为其余各组间的3天缓解率差异有统计学意义(Pα′)。(3)症状反复率:E组、F组的消化道症状反复率均要低于A组,差异有统计学意义(P"fα′)。但尚不能认为其余各组间的症状反复率差异有统计学意义(Pα′)。(4)激素副作用发生率:各组间差异均无统计学意义(P0.05)。(5)平均住院天数:各组间差异均无统计学意义(P0.05)。结论:(1)大剂量甲泼尼龙联合奥美拉唑相对于小剂量甲泼尼龙联合西咪替丁或奥美拉唑以及中剂量甲泼尼龙联合西咪替丁儿童腹型过敏性紫癜的疗效更好,起效更快。(2)大剂量甲泼尼龙联合奥美拉唑或西咪替丁相对于小剂量甲泼尼龙联合西咪替丁治疗儿童腹型过敏性紫癜的症状反复率更低。(3)小、中、大甲泼尼龙联合奥美拉唑或西咪替丁治疗儿童腹型过敏性紫癜的激素副作用发生率均较低。(4)小、中、大甲泼尼龙联合奥美拉唑或西咪替丁治疗儿童腹型过敏性紫癜的住院天数并无显著差异。
[Abstract]:Aim: to compare the efficacy and safety of different doses of methylprednisolone combined with different acid suppressants in order to find the best treatment for children with abdominal Henoch-Schonlein purpura. Methods: a total of 300 children with abdominal Henoch-Schonlein purpura were randomly divided into 6 groups (n = 50): A): low dose methylprednisolone combined with cimetidine), B group (low dose methylprednisolone combined omeprazole). Group C (middle dose methylprednisolone combined with cimetidine), D group (middle dose methylprednisolone combined omeprazole), E group) and high dose methylprednisolone combined cimetidine), F group (high dose methylprednisolone combined omeprazole group). Multi-factor statistical method was used to observe the efficacy and safety of each group. Results: (1) one-day remission rate in group F was higher than that in group A, B and C (P "f 伪'). However, there was no significant difference in one-day response rate among the other groups (P 伪'). (2) 3 days remission rate D, E, F group 3-day response rate was higher than that of A group, and P 伪 'remission rate was significantly higher in E and F groups than in A group. The 3-day remission rate of P "f 伪'). F group was significantly higher than that of A, B and C groups (P" f 伪'). However, there was no significant difference in the 3-day remission rate among the other groups (P 伪'). (3): the recurrence rate of digestive tract symptoms in E group and F group was lower than that in A group, and the difference was statistically significant (P "f 伪'). However, there was no significant difference in symptom recurrence rate among the other groups (P 伪'). (4). There was no significant difference in the incidence of hormone side effects between groups (P0.05). (5). There was no significant difference among the groups (P0.05). Conclusion: (1) High-dose methylprednisolone combined with omeprazole is better than small-dose methylprednisolone combined with cimetidine or omeprazole or middle-dose methylprednisolone combined with cimetidine in children with abdominal Henoch-Schonlein purpura. (2) High-dose methylprednisolone combined with omeprazole or cimetidine had a lower symptom recurrence rate than low-dose methylprednisolone combined with cimetidine in the treatment of abdominal Henoch-Schonlein purpura in children. (3) small, middle, High methylprednisolone combined with omeprazole or cimetidine in the treatment of children with abdominal Henoch-Schonlein purpura has a lower incidence of hormone side effects. (4) small, middle, There was no significant difference in hospitalization days of large methylprednisolone combined with omeprazole or cimetidine in children with abdominal Henoch-Schonlein purpura.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5

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