两组不同三联疗法根除幽门螺杆菌感染的成本-效果分析

Cost-effective analysis of two types of triple-therapy in Hpylori eradication

目的探讨不同药物治疗方案根除幽门螺杆菌的药物经济学评价。方法根据文献选择82例经14碳-尿素酶呼吸试验(14C-UBT)和Hp-IgG抗体检查均为阳性的门诊患者。行胃镜检查。组织病理学诊断为浅表性胃炎,萎缩性胃炎和消化性溃疡,将患者随机分为A、B两组,分别给予:奥美拉唑20mg2次/d,阿莫西林1000mg2次/d,呋喃唑酮100mg2次/d口服(A组);奥美拉唑20mg2次/d,阿莫西林1000mg2次/d,甲硝唑400mg2次/d口服(B组),治疗一周后停药。4w后复查14C-UBT。运用药物经济学的成本-效果分析方法进行分析评价。结果2种药物治疗方案总成本分别A组16944.58元,B组19615.2元。Hp的根除率分别为A组84.21%(32/38)。B组63.64%(28/44)。结论A组方案具有更好的成本-效果,在临床Hp根除治疗方案选择时值得考虑。

Objective To analyze the cost and effect of two types of triple-therapy for h pylori eradication. Methods Eighty-two c-UBT and Hp-IgG positive out-patients with chronic superficial gastritis,atrophic gastritis, or peptic ulcer diagnosed by gastroscopy were randomly divided group A and B.The patients in group A received therapy （Omerprazole 20mg plus Amoxicillin 1000mg,twice a day respectively）and the ones in group B treated with Omeprazole 20mg, Amoxicillin 1000mg,plus Flagyl 400mg,twice a day respectively.Both treatments persisted for one week. The C-UBT of each patient was measured again after four weeks.Total costs were calculated. Resuits The total cost of group A was 16,944.58RMB and group B was 19,615.2RMB.The eradicative ratio was 84.21%（32/38）in group A and 63.64%（28/44）in group B. Conclusion Omeprazole plus Amoxicillin therapy presents a better cost-effective rate in Hpylori eradication and should be recommended.