消化性溃疡两种四联疗法的药物经济学评价  

Pharmacoeconomic evaluation of two quadruple therapies on peptic ulcer

作　　者：刘梅[1] 许多 马小芬 刘子修[1] 陆瑜[1] LIU Mei;XU Duo;MA Xiao-fen(Department of Pharmacy, the 454th Hospital of PLA, Nanjing, Jiangsu 210002, China)

机构地区：[1]解放军第454医院药学部,江苏南京210002

出　　处：《中华全科医学》2018年第5期845-848,共4页Chinese Journal of General Practice

基　　金：江苏省药学会-奥赛康医院药学基金(A201405)

摘　　要：目的比较奥美拉唑四联疗法与兰索拉唑四联疗法治疗消化性溃疡的疗效,并对其进行药物经济学评价分析,为临床治疗提供参考。方法选择2015年1月—2016年12月就诊于解放军第454医院,经胃镜诊断为胃或十二指肠溃疡,C14尿素呼吸试验和快速尿素酶检查呈阳性患者136例,采用随机数字法分为奥美拉唑组和兰索拉唑组,每组各68例。2组均联合胶体果胶铋,200 mg/次,3次/d;阿莫西林克拉维酸钾,600 mg/次,2次/d;克拉霉素,500 mg/次,1次/d。奥美拉唑组加用奥美拉唑,20 mg/次,1次/d。兰索拉唑组加用兰索拉唑,30 mg/次,1次/d。服用1个疗程(30 d)后进行评价疗效及成本-效果分析。结果兰索拉唑组,治疗溃疡有效为94.12%、C14尿素呼吸试验阴性率为92.65%、快速尿素酶检查呈阳性为92.65%;奥美拉唑四联治疗组治疗溃疡有效为89.71%、C14尿素呼吸试验阴性率为89.71%、快速尿素酶检查呈阳性为91.18%,兰索拉唑四联治疗方案治愈率高于奥美拉唑四联治疗方案,但差异无统计学意义。增量效果分析要多获得1个效果单位,需要花费215.38元,可被患者接受。结论综合评价兰索拉唑四联治疗方案较奥美拉唑四联治疗方案有一定的优势。Objective To analyze and contrast the curative effect, safety and pharmacoeconomics meaning of OME （omeprazole） quadri-combination therapy and Lansoprazole quadri-combination therapy on treating peptic ulcer, which could provide reference for clinical use. Methods We collected 136 patients, treated in No. 454 Hospital from January, 2015 to December, 2016, who suffered from gastric or duodenal ulcer, with positive results from C4-urea breath test and rapid urease test. The patients were randomly divided into OME group and Lansoprazole group, with 68 patients in each group. The two groups were given combined colloidal bismuth pectin, 200 mg/time, 3 times/d, amoxieillin and potassi- um clavulanate, 600 mg/time, 2 times/d, and clarithromycin, 500 mg/time, 1 time/d treatment. We added OME to the patients in OME group, 20 mg/time, 1 time/day, and Lansoprazole to the patients in Lansoprazole group, 30 rag/time, 1 time/day, and then evaluated the curative effect and did the cost-effect analysis after one course of treatment （30 days）. Results In OME group, the curative rate of treating ulceration is 94.12%, negative rate of C4-urea breath test is 92.65%, and negative rate of rapid urease test is 92.65% ; in Lansoprazole group the curative rate of treating ulcera- tion is 89.71% , negative rate of C4-nrea breath test is 89, 71% , and negative rate of rapid urease test is 91.18% ; The curative rate of Lansoprazole quadri-combination therapy is higher than OME quadri-combination therapy, without signifi- cant difference. The additional expenditure could be accepted by patients who pay 215.38 RMB for improving one effec- tive unit. Conclusion Lansoprazole quadri-combination therapy is better than OME quadri-combination therapy.

关 键 词：奥美拉唑 兰索拉唑 C14尿素呼吸试验 快速尿素酶 药物经济学评价 

分 类 号：R573.1[医药卫生—消化系统] R975.6[医药卫生—内科学]