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目的 比较 3种治疗方案愈合十二指肠溃疡、根除幽门螺杆菌 (Hp)的费用 -效果关系 ,寻找有效价廉适合农村推广的Hp根除方案。方法 将 90例十二指肠溃疡患者随机分成OMC组 (奥美拉唑 +克拉霉素+甲硝唑 )、RFT组 (雷尼替丁 +呋喃唑酮 +四环素 )、RMG组 (雷尼替丁 +甲硝唑 +庆大霉素 ) ,每组 3 0例 ,作为分析模型。分别以溃疡愈合与Hp根除为观察终点 ,进行费用 -效果分析。结果 OMC ,RFT和RMG组的溃疡愈合率分别为 96 7% ,86 7%和 80 0 % ,3组差异无显著性 (P >0 0 5 )。Hp根除率分别为 96 7% ,90 0 %和66 7% ,前两组比较差异无显著性 (P >0 0 5 ) ,但均显著高于RMG组 (P <0 0 5 )。RFT方案每愈合 1例溃疡的费用为 3 7 5元 ,比OMC方案节省 12 3 5 9元 ;每根除 1例Hp感染费用为 3 6 1元 ,比OMC方案节省 12 3 7 3元 ,两组效果比率为 0 0 3。而RFT方案比RMG为 0 9。结论 RFT方案治疗十二指肠溃疡疗效好 ,副作用少 ,比OMC方案有更好的费用 -效果关系 ,值得在经济欠发达的农村推广应用
Objective To compare the cost-effectiveness relationship of three kinds of treatment regimens in healing duodenal ulcer and eradicating Helicobacter pylori (Hp) in order to find an effective and inexpensive Hp eradication program for rural extension. Methods 90 patients with duodenal ulcer were randomly divided into OMC group (omeprazole + clarithromycin + metronidazole), RFT group (ranitidine + furazolidone + tetracycline), RMG group (ranitidine + Metronidazole + gentamicin), 30 cases each group, as the analysis model. Were ulcer healing and Hp eradication were the end points, cost-effectiveness analysis. Results The rates of ulcer healing in OMC, RFT and RMG groups were 96.7%, 86.7% and 80.0%, respectively. There was no significant difference between the three groups (P> 0.05). The eradication rates of Hp were 96.7%, 90.0% and 66.7% respectively. There was no significant difference between the two groups (P> 0.05), but they were significantly higher than that of RMG group (P <0.05). In the RFT program, the cost of healing 1 ulcer per patient was 375 yuan, which was 12 3 59 yuan less than that of the OMC program. For each 1 case, the cost of infection was 361 yuan, which was 12 3 7 3 yuan less than that of the OMC program. The effect rate is 0 0 3. The RFT scheme is 0.9 for RMG. Conclusion RFT regimen has good curative effect and less side effects in the treatment of duodenal ulcer, which has a better cost-effect relationship than OMC plan and worth to be popularized and applied in economically underdeveloped rural areas