三种非铋剂四联方案治疗H.pylori阳性消化性溃疡的疗效及成本-效果分析

Analysis for the cost-effectiveness ratio of three kinds of non-tantalum four-link schemes in treatment of Hp-positive peptic ulcer

目的观察三种非铋剂四联方案治疗H.pylori阳性消化性溃疡的疗效及成本-效果分析。方法收治的112例H.pylori阳性消化性溃疡随机分为3组,ST组38例行序贯疗法,CT组36例行伴同疗法,HT组38例行镶嵌疗法。3组患者均于治疗前及停药2周后进行胃镜检查,记录溃疡部位、数目、大小及周围炎性反应情况,记录患者治疗前后症状体征,比较溃疡愈合率、H.pylori清除率和不良反应,核算治疗费用及成本-效益比。结果治疗后CT组总有效率为88.89%,ST组为84.21%,HT组为94.74%;HT组总有效率明显高于其他2组(P<0.05),CT组与ST组比较差异无统计学意义(P>0.05)。治疗后CT组H.pylori清除率为88.89%,ST组为78.94%,HT组为92.11%;HT组H.pylori清除率明显高于其他2组(P<0.05),CT组与ST组比较差异无统计学意义(P>0.05)。3组治疗期间均无消化大出血等严重不良反应,CT组不良反应率为22.22%,ST组为23.68%,HT组为34.21%,HT组不良反应率明显高于其他2组(P<0.05)。CT组成本-效益比为2.26,ST组为2.79,HT组为1.85,HT组明显低于其他2组(P<0.05)。CT组复发率为19.44%,ST组为15.79%,HT组为7.89%,HT组明显低于其他2组(P<0.05)。结论镶嵌疗法治疗H.pylori阳性消化性溃疡溃疡愈合率高,H.pylori根除率高,费用低,适宜在本地区基层医院推广。

Objective To analyze the the efficacy and cost-effectiveness ratio of three kinds of non-tantalum four-link schemes in treatment of Hp-positive peptic ulcer.Methods A total of 112 patients with Hp-positive peptic ulcers were randomly divided into 3 groups.The 38 patients in ST group were treated by sequential therapy,and the 36 patients in CT group were treated by concomitant therapy,and the other 38 patients in HT group were treated by inlay therapy.Gastroscopic examination was performed before treatment and at 2 weeks after treatment.The location,number,size and surrounding inflammatory reaction of ulcer were observed.Moreover the symptoms and signs of patients before and after treatment, and ulcer healing rate,Hp clearance rate,adverse reactions,treatment costs and cost-benefit ratio were observed and compared among the three groups.Results The total effective rate in CT group was 88.89%,which was 84.21% in ST group and 94.74% in HT group.The total effective rate in HT group was significantly higher than that in the other two groups(P<0.05),however,there was no significant difference between CT group and ST(P<0.05).The Hp clearance rate in CT group was 88.89%,which was 78.94% in ST group and 92.11% in HT group.The Hp clearance rate in HT group was significantly higher than that in the other two groups(P<0.05),however,there was no significant difference between CT group and ST(P<0.05).Moreover there were no serious adverse reactions including digestive hemorrhage in the three groups during treatment.The adverse reaction rate was 22.22% in CT group,23.68% in ST group,and 34.21% in HT group.The adverse reaction rate in HT group was significantly higher than that in the other two groups(P<0.05).The results showed that the cost-efficiency ratio was 2.26 in CT group, which was 2.79 in ST group and 1.85 in HT group,which in HT group was significantly lower than that in the other two groups(P<0.05).The relapse rate was 19.44% in CT group,15.79% in ST group and 7.89% in HT group,which in HT group was significantly lower than that in the other two groups(P<0.05).Conclusion Inlaid therapy in treatment of Hp-positive peptic ulcer has higher healing rate,higher Hp eradication rate and lower cost,which is suitable for promotion in primary hospitals in the region.