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目的不同质子泵抑制剂四联疗法治疗幽门螺杆菌(Hp)阳性十二指肠球部溃疡的药物经济学评价。方法将120例Hp阳性十二指肠球部溃疡患者随机均分为四组,分别采用奥美拉唑(A组)、兰索拉唑(B组)、埃索美拉唑(C组)和雷贝拉唑(D组)四联疗法治疗,分析各组Hp根除率、溃疡治疗有效率、不良反应发生率以及CYP2C19基因型,并通过药物经济学评价方法比较各组治疗方案的成本-效果比和增量成本-效果比。结果四组在治疗十二指肠球部溃疡患者中的Hp根除率、溃疡治疗有效率、不良反应发生率以及CYP2C19基因型检测方面均无统计学差异(P>0.05);但A组在Hp根除率及溃疡治疗有效率方面的成本-效果比值最低,方案最经济。结论质子泵抑制剂四联疗法是Hp阳性十二指肠球部溃疡安全、有效的治疗方案;其中,奥美拉唑最为经济,临床可依据患者具体情况选择药物。
OBJECTIVE: To evaluate the pharmacoeconomic evaluation of Hp-positive duodenal ulcer with different proton pump inhibitor quadruple therapy. Methods One hundred and twenty patients with Hp-positive duodenal ulcer were randomly divided into four groups: omeprazole (group A), lansoprazole (group B), esomeprazole (group C) And rabeprazole (group D), the Hp eradication rate, the effective rate of the ulcer treatment, the incidence of adverse reactions and CYP2C19 genotypes were analyzed. The cost of each treatment group was compared by the pharmacoeconomic evaluation method - Effect ratio and incremental cost - effect ratio. Results There was no significant difference between the four groups in the treatment of duodenal ulcer in patients with Hp eradication rate, effective rate of treatment of ulcers, the incidence of adverse reactions and CYP2C19 genotype detection (P> 0.05); but A group in Hp Eradication rates and the effectiveness of the treatment of ulcers cost - effect of the lowest ratio, the most economical program. Conclusion Proton pump inhibitor quadruple therapy is a safe and effective treatment for Hp-positive duodenal ulcer. Among them, omeprazole is the most economical, clinical choice of drugs based on the specific circumstances of patients.