噻托溴铵、布地奈德/福莫特罗与异丙托溴铵治疗慢性阻塞性肺疾病的临床疗效和药物经济学评价  

Medicine Economic Evaluation and Clinical Efficacy of Tiotropium Bromide,Budesonde/Formotero and Ipratropium Bromide for Patients with COPD

作　　者：王娜 许恩喜 陈昕晟 房树华 汪毅 盛玉青 于绍帅 王艳 WANG Na;XU En-xi;FANG Shu-hua(Zhenjiang First People's Hospital,Zhenjiang Jiangsu 212000,China)

机构地区：[1]镇江市第一人民医院,江苏镇江212000

出　　处：《湖北科技学院学报（医学版）》2020年第5期405-408,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

基　　金：江苏省药学会-天晴临床药学基金科研项目(Q2018180)。

摘　　要：目的开展对噻托溴铵粉吸入剂、布地奈德/福莫特罗粉吸入剂与异丙托溴铵气雾剂在临床治疗慢性阻塞性肺疾病(COPD)患者的临床疗效评估和药物经济学研究,为临床用药决策提供依据。方法采用随机平行的对照试验设计,将符合标准的55例COPD患者分为3组,分别为A组(噻托溴铵粉吸入剂,18μg/次,1次/d)、B组(布地奈德/福莫特罗粉吸入剂,160μg/4.5μg/吸,2吸/d);C组(异丙托溴铵气雾剂,40μg/次,3次/d),随访6个月。研究期间通过测定患者肺功能、使用圣乔治呼吸问题调查问卷(sGRQ)评估患者临床疗效,使用决策树模型对3种治疗方案的成本与效果进行分析。结果3组患者治疗6个月后肺功能指标、圣乔治问卷评分较治疗前均有明显改善(P均<0.05);A、B、C组有效率分别为88.89%、89.47%和83.33%,成本-效果比分别为36.44、41.19和38.37;A-B、B-C、A-C增量成本效果比分别为-76943.10、7945.11、747.48。结论在治疗COPD过程中,A组和B组临床疗效相当,C组稍弱,A组更具有成本-效果性。Objective To develop the clinical efficacy and cost-effectiveness analysis of tiotropium bromide powder inhalant,budesonide/formoterol powder inhalant and ipratropium bromide aerosol in the treatment of patients with chronic obstructive pulmonary disease(COPD).Methods 55 patients were randomly divided into three groups.The Patients ingroup A were given tiotropium bromide powder inhalation at 18μg once daily,patients in group B were given budesonide/formoterol powder inhalation agent at 160μg/4.5μg twice a day,and patients in group C were given ipratropium bromide aerosol at 40μg three times a day.The trial was followed up for 6 months.During the study,the clinical efficacy was assessed by measuring their lung function and sGRQ,and decision tree model was built to analyze the cost-effectiveness ratio of the three groups.Results Patient's lung function index and sGRQ in the three groups were significantly improved 6 months after treratment(P<0.05),the effective rates of group A,B and C were respectively 88.89%,89.47%and 83.33%,and the cost-effectiveness ratios were respectively 36.44,41.19 and 38.37.The incremental cost-effectiveness ratio of A-B,B-C and A-V are-76943.10,7945.11 and 747.48,respectively.Conclusion In the treatment of COPD,group A and group B had the same clinical efficacy,and group A was more cost-effective.

关 键 词：COPD 噻托溴胺 布地奈德/福莫特罗 异丙托溴铵 临床疗效 成本-效果分析 

分 类 号：R563.3[医药卫生—呼吸系统]