两种质子泵抑制剂治疗幽门螺杆菌阴性胃溃疡的药物经济学评价

Pharmacoeconomics Evaluation on 2 Proton Pump Inhibitors in Treatment of Helicobacter Pylori-negative Stomach Ulcer

目的:应用药物经济学原理分析奥美拉唑与兰索拉唑治疗幽门螺旋杆菌(Hp)阴性胃溃疡成本-效果,为合理用药提供科学依据。方法:选择符合标准的患者87例,分为奥美拉唑组44例和兰索拉唑组43例,疗程结束时评价临床效果及成本-效果。结果:奥美拉唑组患者治愈23例、显效9例、有效5例、无效7例,总有效率84.09%;兰索拉唑组患者治愈24例、显效10例、有效4例、无效5例,总有效率88.37%,差异无统计学意义(χ2=0.335,P=0.563)。奥美拉唑组C/E为0.46,低于兰索拉唑组的1.99,△C/△E为89.65,差异具有统计学意义(P<0.05)。敏感度分析示奥美拉唑组C//E为0.41,低于兰索拉唑组的1.79,ΔC//ΔE为89.45,差异具有统计学意义(P<0.05)。奥美拉唑组不良反应发生率4.55%,与兰索拉唑组6.98%相似,差异无统计学意义(P>0.05)。结论:奥美拉唑治疗Hp阴性胃溃疡具有更高的药物经济学价值,可减少医疗资源浪费。

Objective： To analyze the cost-effectiveness ratios of omeprazole and lansoprazole in treatment of Helicobacter pylori（ Hp）-negative stomach ulcer by pharmacoeconomics principles,and to provide scientific foundations for rational use of drug.Method： A total of 87 eligible patients were selected and divided into omeprazole group（ 44 patients） and lansoprazole group（ 43 patients）. At the end of treatment,the cost-effectiveness ratios and clinical effect were evaluated. Result： Of the omeprazole group,23 patients were cured,9 patients were responsive to the treatment excellently,5 patients were responsive to the treatment,and 7 patients were unresponsive to the treatment,and the total effective rate was 84.09%; while of the lansoprazole group,24 patients were cured,10 patients were responsive to the treatment excellently,4patients were responsive to the treatment,and 5 patients were unresponsive to the treatment,and the total effective rate was 88.37%; and the difference was statistically insignificant（ χ^2= 0.335,P = 0.563）. The C / E of the omeprazole group was 0.46,which was lower than that of the lansoprazole group（ 1.99）,the △C / △E was 89.65,and the difference was statistically significant（ P〈0.05）. Sensitivity analysis showed the C / / E of the omeprazole group was 0.41,which was lower than that of the lansoprazole group（ 1. 79）,the ΔC / / ΔE was 89.45,and the difference was statistically significant（ P〈0.05）. The incidence of adverse reactions of the omeprazole group was 4.55%,was similar to the lansoprazole group（ 6. 98%）,and the difference was statistically insignificant（ P〉0.05）.Conclusion： Omeprazole in treatment of Hp-negative stomach ulcer has higher pharmacoeconomics values,and can reduce medical resources waste.