不同质子泵抑制剂四联疗法治疗消化性溃疡的安全性及成本-效益分析  

Safety and Cost-effectiveness Analysis of Four Combination Therapy with Different Proton Pump Inhibitors for the Treatment of Peptic Ulcers

作　　者：金晨 刘莹 王革丽 JIN Chen;LIU Ying;WANG Ge-Li(Department of Gastroenterology,Fuxin Mine General Hospital,Liaojian Group,Fuxin 123000,China;Department of Pediatrics,Fuxin Mine General Hospital,Liaojian Group,Fuxin 123000,China)

机构地区：[1]辽健集团阜新矿总医院消化内科,辽宁阜新123000 [2]辽健集团阜新矿总医院儿科,辽宁阜新123000

出　　处：《中国药物经济学》2025年第3期77-80,85,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨不同质子泵抑制剂四联疗法治疗消化性溃疡的安全性及成本-效益。方法选取2021年1月至2024年1月辽健集团阜新矿总医院收治的100例消化性溃疡患者,按随机数字表法分为1、2、3、4组,每组25例。所有患者均采用质子泵抑制剂+克拉霉素+阿莫西林+胶体果胶铋治疗,1组患者质子泵抑制剂为奥美拉唑,2组为泮托拉唑,3组为雷贝拉唑,4组为兰索拉唑。比较4组患者临床疗效,治疗前后α-防御素、转化生长因子-β1(TGF-β1)及胃泌素表达水平变化,不良反应发生率,成本-效益。结果4组治疗总有效率比较差异无统计学意义(P>0.05);治疗后4组α-防御素水平高于治疗前(P<0.05),TGF-β1、胃泌素水平低于治疗前(P<0.05),但治疗前后4组α-防御素、TGF-β1、胃泌素水平比较无明显差异(P>0.05);4组不良反应发生率比较无明显差异(P>0.05);4组C/E从低到高为3组、1组、2组、4组。结论质子泵抑制剂四联疗法治疗消化性溃疡疗效显著,可改善患者胃肠激素表达水平,且4种不同质子泵抑制剂总有效率、安全性及对胃肠激素水平的影响并无显著差异,但采用雷贝拉唑成本-效益更优,可作为治疗消化性溃疡的首选药物。Objective To explore the safety and cost-effectiveness of different proton pump inhibitors quadruple therapy in the treatment of peptic ulcers.Methods A total of 100 patients with peptic ulcer admitted to Fuxin Mine General Hospital of Liaojian Group from January 2021 to January 2024 were selected and divided into 1,2,3 and 4 groups according to random number table method,with 25 cases in each group.All patients were treated with proton pump inhibitor+clarithromycin+amoxicillin+colloidal pectin bismuth.Preprazole was used as proton pump inhibitor in group 1,pantoprazole in group 2,rabeprazole in group 3,and Lansoprazole in group 4.The clinical efficacy,expression levels ofα-defencin,transforming growth faction-β_1(TGF-β_1)and gastrin before and after treatment,incidence of adverse reactions and cost-effectiveness of the 4 groups were compared.Results There was no significant difference in the total effective rate among the 4 groups(P>0.05).After treatment,the level ofα-defandrin in 4 groups was higher than before treatment(P<0.05),and the levels of TGF-β_1 and gastrin were lower than before treatment(P<0.05),but there were no significant differences in the levels ofα-defandrin,TGF-β_1 and gastrin in 4 groups before and after treatment(P>0.05).There was no significant difference in the incidence of adverse reactions among the 4 groups(P>0.05).4 Groups C/E from low to high are 3,1,2,and 4 groups.Conclusion Tetrad therapy with proton pump inhibitors has a significant effect on the treatment of peptic ulcer,and can improve the expression level of gastrointestinal hormone in patients,and there is no significant difference in the total effective rate,safety and impact on gastrointestinal hormone levels of the four different proton pump inhibitors.However,the use of rapeprazole is more cost-effective and can be used as the first choice for the treatment of peptic ulcer.

关 键 词：质子泵抑制剂 四联疗法 消化性溃疡 安全性 成本-效益 胃肠激素 

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