磺脲类药物用于2型糖尿病的成本-效果评价

Cost-effectiveness evaluation of sulfonylureas in type 2 diabetes mellitus

目的探讨磺脲类药物用于2型糖尿病的成本-效果,为临床医师选择合理用药方案提供参考。方法选择康平县人民医院2017年8月到2019年12月诊治的180例2型糖尿病患者为研究对象,依据随机数字表法,将研究对象分为三组—A、B、C组(每组60例),A组采用二甲双胍缓释片联合格列美脲,B组采用阿卡波糖联合格列美脲,C组采用罗格列酮联合格列美脲,比较三组2型糖尿病患者的用药有效率、C/E值、成本以及血糖控制情况。结果C组的临床总有效率(93.33%)高于A组、B组,但差异无统计学意义(P>0.05);C组各检测时段的血糖下降百分率均高于A组和B组,差异有统计学意义(P<0.05);C组C/E值(23.25)、平均血糖下降率(35.72%)、成本(846.20元)均高于A组和B组,B组的C/E值(18.86)、成本(485.52元)高于A组,但其平均血糖下降率(26.24%)与A组对比,差异无统计学意义(P>0.05)。结论三种联合用药方案均可有效治疗2型糖尿病,但二甲双胍缓释片与格列美脲联合用药方案的的成本-效果最佳。

Objective:To investigate the cost-effectiveness of sulfonylureas in the treatment of type 2 diabetes mellitus(T2DM),so as to provide reference for clinicians to choose rational drug use.Methods:A total of 180 patients with type 2 diabetes treated in People's Hospital of Kangping County from August 2017 to December 2019 were selected as the research objects.According to the random number table method,the subjects were divided into three groups-group A,group B and group C(60 cases in each group),Group A was treated with metformin sustained-release tablets combined with glimepiride,Group B was treated with acarbose combined with glimepiride,Group C was treated with rosiglitazone combined with glimepiride.The effective rate,C/E value,cost and blood glucose control of the three groups were compared.Results:The total effective rate of group C(93.33%)was higher than that of group A and group B,but the difference was not statistically significant(P>0.05);the percentage of blood glucose decrease in group C was higher than that in group A and group B,the difference was statistically significant(P<0.05);the C/E value(23.25),the average blood glucose decrease rate(35.72%)and the cost(846.20yuan)in group C were higher than those in group A and group B.The C/E value(18.86)and cost(485.52yuan)in group B were higher than those in group A,but the average blood glucose decrease rate(26.24%)was compared with group A,the difference was not statistically significant(P>0.05).Conclusion:The three combined drug regimens can effectively treat type 2 diabetes,but the cost-effectiveness of metformin sustained-release tablets combined with glimepiride is the best,which is worthy of clinical application.