Follow-up of children with cyclic vomiting syndrome: Combination therapy effects and clinical features
10.3760/cma.j.issn.1673-4912.2022.02.005
- VernacularTitle:儿童周期性呕吐综合征联合用药的治疗效果及临床特点随访
- Author:
Shu GUO
1
;
Dexiu GUAN
;
Tianlu MEI
;
Feihong YU
;
Jin ZHOU
;
Guoli WANG
;
Huiqing SHEN
;
Jing ZHANG
;
Jie WU
;
Xiwei XU
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院消化科 100045
- Keywords:
Cyclic vomiting syndrome;
Children;
Prophylactic therapy;
Follow-up
- From:
Chinese Pediatric Emergency Medicine
2022;29(2):99-103
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of combination therapy on cyclic vomiting syndrome(CVS)in children, and improve the efficacy of CVS treatment in the future.Methods:This study retrospectively analyzed patients′ medical records of CVS, which were admitted to Digestive Department of Beijing Children′s Hospital from 2012 to 2019.The treatment regimen was A(Cyproheptadine+ Doxepin+ Valproate), B(Propranolol+ Cyproheptadine), or C(Propranolol+ Amitriptyline). Meanwhile, the patients should take drugs more than three months.The clinical data of 42 cases were analyzed retrospectively, and the treatment effect after discharge was followed up by telephone until October, 2020.Results:Among the 42 cases, 17 were male and 25 were female, whose mean age of onset was (4.65±3.23) years, and the age of diagnosis was (6.79±3.58) years.The main accompanied symptoms were abdominal pain and upper gastrointestinal bleeding.Forty-two patients were moderate/severe CVS.The regimens A, B and C were observed in 7, 11, and 24 patients, respectively.The age at improvement was(8.17±4.12)years.The course of treatment was(1.37±0.96)years.The age at follow-up was(10.32±4.03)years.During the 1-year follow-up, 35 cases were effective, and the efficiency was 83.3%.Among them, 23 cases had no paroxysmal vomiting and 7 cases had no effect.There was no significant difference in therapy effects among group A, B and C. Between the effective group and non-effective group, there were statistical differences in the personal history of hiatus hernia( P=0.024), the weight at follow-up ( P=0.042), and the course of medication( P=0.020). Conclusion:The combination regimen has a higher effective rate in the treatment of CVS.There was no significant difference among the three regimens in the treatment of CVS.For children with refractory CVS, who can not be treated with combination therapy, individualized therapy should be further developed.
