米格列醇与阿卡波糖治疗2型糖尿病的药物经济学研究

Pharmacoeconomic Study on Miglitol and Acarbose in the Treatment of Type 2 Diabetes

目的:比较米格列醇与阿卡波糖治疗2型糖尿病的药物经济学效果。方法:将2017年9月至2018年8月解放军第910医院门诊收治的2型糖尿病患者100例按就诊顺序分为两组,单号为米格列醇组,双号为阿卡波糖组,每组50例。米格列醇组患者口服米格列醇片治疗,阿卡波糖组口服阿卡波糖片治疗。两组患者均联合二甲双胍治疗,疗程为12周。观察两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 hPBG)及糖化血红蛋白(HbA1c)水平,并以FBG、2 hPBG及HbA1c水平评估疗效,运用药物经济学原理进行成本-效果分析。结果:治疗12周后,两组患者FBG、2 hPBG及HbA1c水平均较治疗前明显降低,且米格列醇组患者上述指标水平降低程度较阿卡波糖组更为明显,差异均有统计学意义(P<0.05)。米格列醇组方案上述3项指标疗效的成本-效果比均低于阿卡波糖组,且阿卡波糖组方案相对于米格列醇组的增量成本-效果比分别为26.04、39.06和11.16。米格列醇组、阿卡波糖组患者的不良反应发生率分别为4.0%(2/50)、8.0%(4/50),差异无统计学意义(P>0.05)。结论:米格列醇能明显降低2型糖尿病患者FBG、2 hPBG和HbA1c水平,临床疗效显著,不良反应少,具有药物经济学优势。

OBJECTIVE:To compare the economical effects of miglitol and acarbose in the treatment of type 2 diabetes.METHODS:Totally 100 patients with type 2 diabetes admitted into No.910th Hospital of PLA from Sept.2017 to Aug.2018 were extracted to be divided into the miglitol group and the acarbose group via the admission sequence,with 50 cases in each group.The miglitol group was treated orally with miglitol,while the acarbose group received acarbose.Both groups were additionally given metformin,the course of treatment was 12 weeks.Clinical efficacy such as fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG),glycated hemoglobin(HbA1c),the levels of FBG,2 h PBG and HbA1c of two groups were observed before and after treatment,cost-effectiveness analysis was performed by using pharmacoeconomics principles.RESULTS:After treatment of 12 weeks,the levels of FBG,2 h PBG and HbA1c in two groups were significantly lower than those before treatment,and the levels of the above indicators in the miglitol group were significantly lower than those in the acarbose group,the differences were statistically significant(P<0.05).The C/E of the three indicators of the miglitol group were lower than those of the acarbose group,and theΔC/ΔE of the acarbose group to the miglitol group was 26.04,39.06 and 11.16,respectively.The incidence of adverse drug reactions in the miglitol group and the acarbose group was 4.0%(2/50)and 8.0%(4/50),respectively,with no significant difference(P>0.05).CONCLUSIONS:Miglitol can significantly reduce the levels of FBG,2 hPBG and HbA1c in patients with type 2 diabetes,with significant clinical efficacy,fewer adverse drug reactions and higher advantages of pharmacoeconomics.