| Background: Helicobacter pylori(Hp)is a microaerobic,helical gram-negative bacterium.Hp is mainly transmitted among people through gastrointestinal secretions,kisses,meals,eating unclean diet and other ways through stomach-mouth,mouth-mouth,fecal-mouth.Hp exists in gastric mucosal epithelium and bottom layer of gastric mucus through chemotaxis,adhesion and colonization after it enters human body through mouth.HP is difficult to remove spontaneously,it is a risk factor for Hp gastritis,Hp-related dyspepsia,gastrointestinal ulcer,gastric MALT lymphoma and other diseases.The International Agency for Research on Cancer(IARC)listed Hp as a carcinogen in 1994.Infections could bring great burden to patients,families and society.Gastrointestinal pyrexia is a state in which invisible heat or tangible heat obstructed in the gastrointestinal tract and causes excessive yang-heat in the gastrointestinal tract.Improper dietary structure and lack of daily exercise cause the body unable to metabolize excess energy.Food accumulates in the gastrointestinal tract and turns into the pathogenic heat.Gastrointestinal retention heat is widely seen in various age groups,especially in children and adolescents.It has become an intrinsic factor affecting the occurrence and development of related diseases.Children with gastrointestinal pyrexia syndrome are more likely to have Helicobacter pylori infection than children without this syndrome.It indicates that gastrointestinal pyrexia may be associated with Helicobacter pylori infection in children.Therefore,we investigate the prevalence and risk factors of Helicobacter pylori infection in children by cross-sectional study.A case-control study was designed to clarify the relationship between gastrointestinal pyrexia and Helicobacter pylori infection in children.To provide new ideas and evidences for clinical prevention and treatment of the disease.The research is divided into literature review and clinical research.Literature review:In this part,two aspects were discussed.(1)The current research progress of Helicobacter pylori infection in children was discussed from the perspective of clinical epidemiology and modern medical research progress.(2)To study the understanding of Helicobacter pylori infection in children from the perspective of etiology and pathogenesis based on Chinese Medicine.clinical research:Objective:1.To explore the prevalence of Helicobacter pylori infection among children aged 3-14 years in Beijing through cross-sectional study.The epidemiological investigation results of Hp infection and the related factors of infection were obtained.This research aims to lay a foundation for further prevention and control of Hp and follow-up research.2.A case-control study was designed to clarify the relationship between gastrointestinal pyrexia and Helicobacter pylori infection in children.The correlation intensity between gastrointestinal pyrexia and Hp infection in children was determined by OR value.To provide evidence for the prevention and treatment of Helicobacter pylori infection from the perspective of etiology of traditional Chinese medicine.3.Exploring the related risk factors of Hp,such as family economic and cultural level,living habits,dietary habits,family history of disease,etc.To provide the evidences for the formulation of relevant interventions.Methods: From July 2018 to February 2019,144 children aged 3 to 14 years old were included in the pediatric department of Dongfang Hospital of Beijing University of Traditional Chinese Medicine(BUCM)and the Third Affiliated Hospital of BUCM according to the including and exclusion criteria of the study.The informed consent forms were signed,and cross-sectional investigation was carried out according to the Diagnostic Scale for Gastrointestinal Pyrexia(Pediatric part-Published)and the case report form(CRF).Microsoft Excel software was used to input data,and SPSS for mac22.0 software was used to analyze the data.To investigate the prevalence and related factors of Hp in children.Then the Hppositive children in this study were taken as case group and 1:3 matched with control group according to baseline data.OR was obtained by calculating the number of children with gastrointestinal pyrexia in case group and control group.Logistic regression was used to analyze the risk factors of Helicobacter pylori infection in children.Experiment 1.Cross-sectional study of Helicobacter pylori infection in childrenA total of 144 subjects were included in this study,23 of them were positive.The prevalence rate of Hp infection in children was 15.97%.Among them,10 male children were infected,and the prevalence rate was 14.08%.13 female children were infected,with rate of 17.81%.The dietary factors in daily life and family history of diseases in children with and without Hp were compared.Chi-square test was used to compare the situation between two groups.It is concluded that children receive food chewed by their guardians,breastfeeding,parents do not disinfect bottles and nipples before and after feeding,children do not wash their hands before meals,children do not wash their hands after defecation,children keep pets at home,children like to cuddle pets,smoking parents,mouth to mouth kiss between parents and children,father uses less toothbrush every year,mother uses less toothbrush every year,father brushes his teeth less often every day,sharing tableware and water cups in families,Hp infection history of family members,history of digestive diseases of parents,children's preference for roadside food,children's preference for meat,choosy in food,drinking tap water,reading or watching TV while eating,and gastrointestinal pyrexia were correlated with Hp infection in children.Experiment 2: A case-control study was designed to investigate the correlation between gastrointestinal pyrexia and Hp infection.Children infected with Hp in Experiment 1 were taken as case group,and 1:3 matched children with baseline data of age,sex,height and weight in control group.There were 23 cases in the case group and 69 cases in the control group.In the case group,18 children had gastrointestinal pyrexia,while in the control group,14 children had accumulated heat.OR of gastrointestinal pyrexia and Helicobacter pylori infection in children was 14.143(P=0.000<0.05,95%CI:4.471-44.733).The items such as dietary factors in children's daily life and family history of diseases were taken as exposure factors.To explore the relationship between these factors and Helicobacter pylori infection.Using the binary logistic regression of Spss software,combined with clinical significance,the positive variables were screened and the multivariate logistic regression model was used to analyze.Screening variables by progressive method,ainput=0.05,aoutput=0.10,combined with clinical significance,screening out highly educated father(OR=0.322,P=0.047<0.05,95% CI: 0.105-0.987),number of toothbrushes used by mother every year(OR = 0.335,P = 0.002 < 0.05,95% CI: 0.167-0.667),mouth to mouth kiss between family members and children(OR=6.261,P=0.023<0.05,95%CI:1.282-30.574)and children's preference for meat(OR=6.334,P=0.032<0.05,95%CI:1.170-34.297)were correlated with Hp infection in children.The items such as dietary factors in children's daily life and family history of diseases were taken as exposure factors.To explore the relationship between these factors and gastrointestinal pyrexia.Using the binary logistic regression of Spss software,combined with clinical significance,the positive variables were screened and the multivariate logistic regression model was used to analyze.Screening variables by progressive method,ainput=0.05,aoutput=0.10,combined with clinical significance,screening out mouth to mouth kiss between family members and children(OR=4.493,P=0.012<0.05,95CI%:1.383-14.599)increasing number of toothbrushes used by father every year(OR=0.634,P=0.004<0.05,95CI%:0.465-0.864),increasing number of times children brush their teeth every day(OR=0.298,P=0.038<0.05,95CI%:0.095-0.936)and children's preference for meat(OR=2.947,P=0.013<0.05,95CI%:1.259-6.900)were correlated with gastrointestinal pyrexia in children.Conclusion: 1.In this study,the prevalence rate of Hp infection in children was 15.97%,and the infection rate in children was still at a high level.In addition,China has a large population of children,so the prevention and treatment of Hp infection in children still deserves attention.2.Gastrointestinal pyrexia is highly associated with Hp infection in children.A healthy diet that encourages children to eat more fresh fruits and vegetables and less high-calorie food can not only prevent the development of gastrointestinal heat accumulation in children but also reduce the potential risk of Hp infection in children.3.Hp infection in children is related to their family life and eating habits.By avoiding close contact with others,encouraging a light,balanced diet and good hygiene practices,children can help prevent helicobacter pylori infection. |
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