目的比较两种治疗方案（ＯＡ：奥美拉唑＋阿莫西林；ＡＭＴ：阿莫西林＋甲硝唑加泰胃美）愈合十二指肠球部溃疡，根除幽门螺杆菌（Ｈｐ）感染，减少溃疡复发的效率（即费用＿效果）．方法１９９５年采用随机对照临床试验ＯＡ组４６例，ＡＭＴ组４３例，作为分析模型，以上海市三级甲等医院的收费为标准，进行费用＿效果分析．结果ＡＭＴ方案平均每愈合１例溃疡的费用为５４６２５元，较ＯＡ方案节约７５０５１元；每根除１例Ｈｐ感染的费用为７０２３２元，较ＯＡ方案节约１０４０２１元；ＡＭＴ＋三联治疗平均每减少１例溃疡复发的费用为６４０３９元，较ＯＡ＋三联治疗节约７８４１５元．在全部费用中直接医疗费用占绝大部分，且其中主要是首次治疗药品费用．ＯＡ方案与ＡＭＴ方案的费用差别主要由首次治疗的药品费用引起．直接非医疗费用及间接费用在二种方案之间无明显差别．结论同时考虑临床疗效及医疗费用，ＡＭＴ治疗较ＯＡ治疗有更好的费用＿效果，尤其对单发，直径在１ｃｍ及以下的十二指肠球部溃疡优于ＯＡ方案治疗，值得临床推广应用． OBJECTIVE: To compare two treatment regimens (OA: omeprazole + amoxicillin; AMT: amoxicillin + metronidazole plus meteridine) to heal duodenal ulcer, eradicate H. pylori infection, Reduce the effectiveness of ulcer recurrence (ie cost-effectiveness). Methods In 1995, 46 patients in the OA group and 43 in the AMT group were included in the randomized controlled clinical trial as the analysis model, and the cost-effectiveness analysis was conducted based on the charges of the tertiary hospitals in Shanghai. Results The cost of healing 1 case of ulcer per case was 546.25 yuan, which was 75051 yuan less than that of OA. The cost of each Hp infection was 70232 yuan per patient, which was 104021 yuan lower than that of OA. The AMT + Triple treatment of an average reduction of 1 case of ulcer recurrence costs 640.39 yuan, compared with OA + triple treatment saves 784.15 yuan. Direct medical costs account for the lion’s share of the total costs, and most of them are for the first time in the treatment of medicines. The difference between the costs of the OA and AMT programs is mainly due to the cost of the first treatment. Direct non-medical expenses and indirect costs in the two programs no significant difference. CONCLUSIONS: Considering both clinical efficacy and medical costs, AMT has a better cost-effectiveness than OA, especially for single-shot, duodenal ulcer with a diameter of 1 cm or less, which is superior to OA for clinical treatment .