不同药物治疗广泛性焦虑障碍的经济学比较

Economic Analysis of Different Drugs in Generalized Anxiety Disorder

目的：比较文拉法辛与西酞普兰对广泛性焦虑障碍（generalizedanxietydisorder，GAD）的成本-效果比。方法：将150例门诊GAD患者随机分为文拉法辛组和西酞普兰组，每组75例。文拉法辛组：第1～7天联合口服文拉法辛75mg和舒必利50mg，每日一次；第7天后仅口服文拉法辛150mg，每日一次；治疗3个月。西酞普兰组：第1～7天联合口服西酞普兰10mg和舒必利50mg，每日一次；第7天后仅口服西酞普兰20mg，每日一次；治疗3个月。于第2、4、12周末对两组患者进行随访，评定药物疗效、不良反应及患者的生活质量，并进行成本-效果分析。结果：第4周、第12周末，文拉法辛组生活质量评分（SF-36）优于西酞普兰组（P〈0．05），第12周末时文拉法辛组有效率高于西酞普兰组（以HAMA量表减分率≥50％为有效），P〈0．05，两组抗抑郁药物不良反应量表（SERS）评分差异无统计学意义。第12周末，成本-效果比分别为17．49和19．31。结论：文拉法辛较西酞普兰在门诊治疗GAD中更具成本-效果优势。

Objeetive：To compare cost-effectiveness in two treatments for generalized anxiety disorder （GAD）. Methods：A to- tal of 150 outpatients with GAD were enrolled and divided into the Venlafaxine group and Citalopram group with 75 cases in each group. The patients in Venlafaxine group administered orally Venlafaxine（75 mg ）and sulpiride（50 mg） once a day for the first seven days and then only took Venlafaxine（150 mg） once a day up to three months. The patients in Citalopram group oral- ly took Citalopram（10 mg ）and Sulpiride（50 rag）once a day for the first seven days and then only took citalopram 20 mg once a day up to three months. Follow-up was conducted at the end of week 2, 4, 12 to evaluate drug efficacy, drug side effects and quality of life. The cost-effectiveness analysis in two groups were compared. Results, The score of quality of life （SF-36） in Venlafaxine group was found to be higher than that in Citalopram group at the end of week 4 and 12 （P〈0.05）. The efficacy rate in Venlafaxine group was higher than that in Citalopram group（the reduction rates of the HAM-A≥50%shoud it was ef- fective）, P〈0.05. However scores of the rating scale for side effeets（SERS） had no statistically difference between the two showed effectivity groups at the end of week 12. The cost-effectiveness ratios in the two groups are 7.49 and 19.31 respectively at the end of week 12. Conclusions： The cost-effectiveness ratio of Venlafaxine is superior to the Citalopram in the outpatient treatment with GAD.