对应用三联方案根除幽门螺杆菌中3种质子泵抑制剂的成本-效果分析

Cost-effectiveness Analysis of Three Kinds of Proton Pump Inhibitors on Helicobacter Pylori

目的针对根除幽门螺杆菌(Hp)的三联方案中的三种质子泵抑制剂进行药物经济学评价,为临床用药提供参考依据。方法选取2016年3月至2017年3月Hp阳性的102例消化道溃疡患者随机分为3组,A组给予奥美拉唑联合甲硝唑以及克拉霉素治疗方案,B组患者给予雷贝拉唑联合甲硝唑和克拉霉素治疗方案,C组患者给予埃索美拉唑联合甲硝唑和克拉霉素,疗程均为10d。每组患者在停药一月后利用成本-效果分析进行经济学评价。结果三组的治疗方案有效率分别为88.24%、91.17%、94.12%,各组间差异并无统计学意义(P>0.05),但成本-效果比值分别为2.11、2.27、3.05,可见A、B组经济学效益显著高于C组,差异具有统计学意义(P<0.05)。结论从药物的经济学效益角度出发可见奥美拉唑以及雷贝拉唑的三联疗法效益相当,同时均显著高于埃索美拉唑,临床具体药物选择时依据患者具体情况而定,做到合理平衡药物使用的实际性和可行性,合理用药。

OBJECTIVE Pharmacokinetic evaluation of the three proton pump inhibitors in the triple regimen of eradication of Helicobacter pylori（Hp）,providing a reference for clinical drugs using. METHODS A total of 102 patients with gastrointestinal ulcers from March 2016 to March 2017 were randomly divided into 3 groups： group A received omeprazole combined with metronidazole and clarithromycin. Group B patients were given rabbits Oxazole combined with metronidazole and clarithromycin treatment program,C group＇s patients were given esomeprazole combined with metronidazole and clarithromycin,all the treatment lasted for 10 day. Each group of patients was evaluated economically using cost-effectiveness analysis after one month of discontinuation. RESULTS The effective rates of the three groups were 88. 24%,91. 17% and 91. 17%,respectively. There was no significant difference between the two groups（P〈0. 05）,but the cost-effectiveness ratio was 2. 61,2. 52,8. 93,and the economic benefit of group was significantly higher than that of group C,the difference was statistically significant（P〈0. 05）. CONCLUSION From the perspective of the economic efficiency of the drug,it is seen that the triple therapy of omeprazole and rabeprazole is quite effective,and it is significantly higher than that of esomeprazole. The specific drug selection depends on the specific condition of the patient,and balancing on the practicality and feasibility of drugs using,and using drugs rationally.