艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价  

Systematic Review of Esomeprazole and Omeprazole in the Treatment of Duodenal Ulcer

作　　者：李国栋[1] 许亚[1] 朱颖[1] 常宁[1] LI Guodong;XU Ya;ZHU Ying;CHANG Ning(Dept.of Pharmacy,Xuzhou Central Hospital,Jiangsu Xuzhou 221009,China)

机构地区：[1]徐州市中心医院药剂科,江苏徐州221009

出　　处：《中国医院用药评价与分析》2020年第11期1359-1364,共6页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:通过艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统分析,对其有效性、安全性及经济性进行评价。方法:计算机检索Pub Med、Cochrane图书馆、外文医学信息资源检索平台、万方数据库、中国期刊全文数据库、中国生物医学文献数据库和中文科技期刊全文数据库等数据库中所有关于艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的相关文献(研究组干预措施为艾司奥美拉唑,对照组干预措施为奥美拉唑),参照纳入、排除标准进行文献筛选,在文献质量评估及其特征描述之后,采用Rev Man 5.2统计软件对文献统计的数据进行荟萃分析(Meta分析),并进行成本-效果分析。结果:纳入10篇文献,均为随机对照试验,共计638例患者。Meta分析结果显示,艾司奥美拉唑治疗十二指肠溃疡或十二指肠溃疡伴出血的总有效率与奥美拉唑基本相当(OR=2.82,95%CI=0.98~8.16,P=0.06;OR=3.36,95%CI=0.95~11.92,P=0.06);艾司奥美拉唑的4周溃疡治愈率明显优于奥美拉唑(OR=2.04,95%CI=1.14~3.67,P=0.02),艾司奥美拉唑1 d、3 d内缓解疼痛症状的效果较奥美拉唑更明显(OR=2.83,95%CI=1.74~4.62,P <0.000 1;OR=3.21,95%CI=1.16~8.84,P=0.02),但两者7 d内缓解疼痛的效果基本相当(OR=1.83,95%CI=0.91~3.68,P=0.09);艾司奥美拉唑的止血时间明显短于奥美拉唑(SMD=-1.82,95%CI=-2.28^-1.36,P<0.000 01);艾司奥美拉唑的不良反应发生率明显低于奥美拉唑(OR=0.28,95%CI=0.14~0.55,P=0.000 3)。但成本-效果分析结果显示,奥美拉唑较艾司奥美拉唑更具药物经济学优势。结论:艾司奥美拉唑治疗十二指肠溃疡的短期疗效优于奥美拉唑,长期疗效方面两者基本相当。本研究中临床用药病例的样本量可能较少并且所纳入的文献质量一般,因此,要获得更具代表性且更加严谨的研究结果,后续研究可作进一步的验证。OBJECTIVE:To systematically evaluate the efficacy,safety and economy of esomeprazole and omeprazole in the treatment of duodenal ulcer.METHODS:PubMed,the Cochrane Library,FMRS,Wanfang Database,CNKI,CBM and Chinese Science and Technology Journal Full-Text Database were retrieved for literature of esomeprazole and omeprazole in the treatment of duodenal ulcer(the intervention was esomeprazole in the study group and omeprazole in the control group).Literature were screened by referring to inclusion and exclusion criteria,and after literature quality assessment and feature description,the RevMan 5.2 statistical software was used for Meta-analysis of literature statistical data and cost-effectiveness analysis.RESULTS:Ten randomized controlled trials(RCT)were collected,including 638 patients.Meta-analysis results showed that the total effective rate of esomeprazole in the treatment of duodenal ulcer or duodenal ulcer with bleeding was basically the same as that of omeprazole(OR=2.82,95%CI=0.98-8.16,P=0.06;OR=3.36,95%CI=0.95-11.92,P=0.06).The four-week cure rate of ulcer of esomeprazole was significantly better than that of omeprazole(OR=2.04,95%CI=1.14-3.67,P=0.02),and the pain relief effect of esomeprazole was more significant than that of omeprazole within 1 d and 3 d(OR=2.83,95%CI=1.74-4.62,P<0.0001;OR=3.21,95%CI=1.16-8.84,P=0.02),but the pain relief effect of the two within 7 d was basically the same(OR=1.83,95%CI=0.91-3.68,P=0.09).The hemostasis time of esomeprazole was significantly shorter than that of omeprazole(SMD=-1.82,95%CI=-2.28--1.36,P<0.00001).The incidence of adverse drug reactions of esomeprazole was significantly lower than that of omeprazole(OR=0.28,95%CI=0.14-0.55,P=0.0003).However,cost-effectiveness analysis showed that omeprazole had an advantage over esomeprazole.CONCLUSIONS:The short-term efficacy of esomeprazole in the treatment of duodenal ulcer is better than that of omeprazole,and the long-term efficacy of the two is basically the same.The sample size of clinical drug cases in this study is

关 键 词：艾司奥美拉唑 奥美拉唑 十二指肠溃疡 药物经济学 META分析 

分 类 号：R975[医药卫生—药品]