不同用药方案治疗甲状腺功能亢进的疗效及药物经济学评价

Efficacy and Pharmacoeconomic Evaluation of Different Medication Regimens in the Treatment of Hyperthyroidism

目的比较不同用药方案治疗甲状腺功能亢进的疗效,并进行药物经济学评价。方法选取湖北省应城市人民医院2019年1月至12月收治的甲状腺功能亢进患者500例,采用随机数字表法分为单药组和联合组,各250例。两组患者均予甲巯咪唑片治疗,联合组患者加用抑亢丸治疗,均连续治疗6个月。结果联合组和单药组的治疗总有效率相当(95.20%比94.00%,P> 0.05),不良反应发生率相当(9.20%比10.80%,P> 0.05);两组患者的心率、体质量指数、临床活动度(CAS)评分、甲状腺功能血清学指标(促甲状腺素、游离三碘甲状腺原氨酸、游离甲状腺素、甲状腺球蛋白抗体、促甲状腺激素受体抗体)、免疫功能血清学指标(白细胞介素6、白细胞介素10、肿瘤坏死因子-α)水平均显著改善(P <0.05),但组间比较,均无显著差异(P> 0.05)。最小成本分析显示,单药组人均成本为659.24元,低于联合组的1 696.95元;敏感度分析显示,单药组人均成本为667.60元,低于联合组的1 549.52元。结论 2种用药方案治疗甲状腺功能亢进均有良好的疗效与安全性,但仅用甲巯咪唑片治疗药物经济性更高。

Objective To compare the efficacy of different medication regimens in the treatment of hyperthyroidism,and to evaluate the pharmacoeconomics. Methods A total of 500 patients with hyperthyroidism admitted to the Yingcheng People’s Hospital from January to December 2019 were selected and divided into the single medicine group and the combined group according to the random number table method,250 cases in each group. The patients in the two groups were treated with Methimazole Tablets,on this basis,the patients in the combined group were treated with Yikang Pills. Both groups were continuously treated for six months. Results The total effective rate of the combined group was similar to that of the single medicine group( 95. 20% vs. 94. 00%,P > 0. 05),and the incidence of adverse reactions of the combined group was similar to that of the single drug group( 9. 20% vs. 10. 80%,P > 0. 05). After treatment,the heart rate( HR),body mass index( BMI),clinical activity score( CAS),serological indexes of thyroid function [ thyroid stimulating hormone( TSH),free triiodothyronine( FT3),free thyroxine( FT4),thyroglobulin antibody( TGAb),TSH receptor antibody( TRAb) ] and serological indexes of immune function [ serum interleukin-6( IL-6),interleukin-10( IL-10) and tumor necrosis factor-α( TNF-α) ] were significantly improved in the two groups,but there was no significant difference between the two groups( P > 0. 05). The minimum cost analysis showed that the per capita cost of the single medicine group was 659. 24 CNY,which was significantly lower than 1 696. 95 CNY of the combined group. The sensitivity analysis showed that the per capita cost of the single medicine group was 667. 60 CNY,which was significantly lower than 1 549. 52 CNY of the combined group. Conclusion Both regimens have good efficacy and safety in the treatment of hyperthyroidism,but using only Methimazole Tablets is more economical.