国产与进口艾司奥美拉唑治疗上消化道出血患者的临床效果和成本-效果分析

Clinical Effect and Cost-effectiveness Analysis of Domestic and Imported Esomeprazole in the Treatment of Upper Gastrointestinal Bleeding

目的探讨国产与进口艾司奥美拉唑治疗上消化道出血患者的临床效果和成本-效果。方法选取2019年5月至2020年5月于昌图县中心医院就诊上消化道出血患者120例作为研究对象,随机分为对照组与观察组,各60例。两组入院后行常规治疗,即止血、纠正水电解质紊乱等,对于失血严重患者可给予一定量血浆、红细胞,并密切注意患者心率、血压及尿量等的变化。同时对照组予以注射用埃索美拉唑钠治疗,观察组应用注射用艾司奥美拉唑钠治疗,比较两组临床疗效、血细胞比容、血红蛋白、胃液pH值、不良反应,并进行经济学分析。结果观察组患者治疗有效率与对照组比较,差异无统计学意义(P>0.05)。治疗前两组患者血细胞比容、血红蛋白、胃液pH值比较差异无统计学意义(P>0.05);治疗后,两组患者血细胞比容、血红蛋白、胃液pH值较治疗前升高(P<0.05),而两组血细胞比容、血红蛋白、胃液pH值比较差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组成本-效果比低于对照组(P<0.05)。敏感性分析结果显示,国产与进口艾司奥美拉唑价格降低10%,观察组患者成本-效果比仍较对照组低(P<0.05)。结论国产与进口艾司奥美拉唑治疗上消化道出血的疗效相当,但采用国产艾司奥美拉唑治疗的成本更低。

Objective To compare domestic and imported esomeprazole in the treatment of upper gastrointestinal bleeding.Methods A total of 120 patients admitted to Changtu County Central Hospital from May 2019 to May 2020 with upper gastrointestinal bleeding were randomly divided into a control group and a experimental group, with 60 cases in each group. After admission, the 2 groups were given routine treatment, that is, hemostasis, correction of water and electrolyte balance, etc. For patients with severe blood loss, a certain amount of plasma and red blood cells could be given, and the vital signs, heart rate, blood pressure and urine volume of patients should be closely observed. At the same time, the control group was treated with imported esomeprazole, and the experimental group was treated with domestic esomeprazole. The clinical efficacy, hematocrit, hemoglobin,pH value of gastric juice, adverse reactions of the 2 groups were compared, and the economic analysis was conducted. Results There was no significant difference in the total effective rate between the experimental group and the control group(P>0.05).Before treatment, there was no significant difference in hematocrit, hemoglobin and pH value of gastric juice between the 2 groups(P>0.05);after treatment, the hematocrit, hemoglobin and pH value of gastric juice in the 2 groups were higher than those before treatment(P<0.05), but there was no significant difference in hematocrit, hemoglobin and pH value of gastric juice between the 2 groups(P>0.05). There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05). The cost-effectiveness ratio of the experimental group were lower than that of the control group(P<0.05). The results of sensitivity analysis showed that the price of domestic and imported esomeprazole was reduced by 10%, and the cost-effectiveness ratio of the experimental group was still lower than that of the control group(P<0.05). Conclusion The efficacy of domestic and imported esomeprazole in the treatment of upper gastrointestinal bleeding is similar, but the cost and economy of domestic esomeprazole are lower.