伏诺拉生二联疗法在首次根治幽门螺旋杆菌感染的疗效观察及经济学评价

Observations on the Efficacy and Economic Evaluation of Two-combination Therapy of Voronasan and PPI in the First Eradication of Helicobacter Pylori Infection

目的对比伏诺拉生二联疗法和质子泵抑制剂(PPI)二联疗法根除幽门螺旋杆菌感染的疗效及药物经济学评价。方法回顾性收集2023年3月至2023年6月确诊Hp感染进行双联疗法治疗符合纳排标准患者,根据用药方案分为三组,所有患者服药疗程均为14天,治疗方案分A组:伏诺拉生(20 mg bid);B组:雷贝拉唑(20 mg bid或10 mg qid);C组:艾司奥美拉唑(40 mg bid或20 mg qid),3组均联合阿莫西林(1次1.0 g tid或1次0.75 g qid)。^(13)C-尿素呼气试验在停药1~2月后复查,分别记录3组治疗Hp的疗效及安全性,并分析三种方案的经济性。结果共纳入174例研究对象,其中男85例,女89例,平均年龄(45.32±13.20)岁,共163例(A组64例、B组48例、C组51例)完成试验。3组Hp根除率显示(A组vs B组vs C组):意向性分析(ITT)(89.71%vs 92.16%vs 90.91%)和符合方案集分析(PP)(90.63%vs 91.67%vs 90.20%),三组Hp根除率及不良反应发生率差异均无统计学意义(P>0.05)。三组治疗方案根据最小成本分析法,A组(成本277.20元)<C组(成本458.64元)<B组(成本553.28元),A组伏诺拉生组为最具经济学意义的治疗方案,敏感性分析后结果一致。结论伏诺拉生二联疗法可作为PPI二联疗法的替代,与雷贝拉唑和艾司奥美拉唑二联疗法相比成本较低,具有经济学优势。

OBJECTIVE Comparison of the efficacy and pharmacoeconomics of helicobacter pylori(Hp)infection eradication by voronasan duotherapy and proton pump inhibitor(PPI)duotherapy.METHODS A retrospective collection of patients diagnosed with Hp infection and treated with dual therapy from March 2023 to June 2023 who met the criteria for natriuresis were divided into three groups according to the medication regimen,and all patients were given a course of medication for 14 days.The treatment regimen was divided into Group A:amoxicillin(1.0 g/d tid or 0.75 g/d qid)in combination with voronasan(20 mg,bid);Group B:amoxicillin in combination with rabeprazole(20 mg,bid or 10 mg,qid);and Group C:amoxicillin in combination with esomeprazole(40 mg,bid or 20 mg,qid).The ^(13)C-urea breath test was repeated after 4-8 weeks of drug withdrawal to observe the Hp eradication rate and the incidence of adverse reactions in the three groups,respectively,and to analyze the economics of the three regimens.RESULTS A total of 174 study subjects were included,including 85 males and 89 females,with an average age of(45.32±13.20)years.A total of 163 cases(64 cases in Group A,48 cases in Group B,and 51 cases in Group C)completed the test.Intentionality analysis(ITT)(89.71%vs 92.16%vs 90.91%)and protocol set compliance analysis(PP)(90.63%vs 91.67%vs 90.20%)showed that the differences in Hp eradication rates among the three groups were not statistically significant(P>0.05),and there were no significant differences in the incidence rates of adverse reactions among the three groups(P>0.05).The three treatment regimens were based on least-cost analysis,Group A(cost RMB 277.20)<Group C(cost RMB 458.64)<Group B(cost RMB 553.28),and Group A voransen group was the most economically significant treatment regimen,with consistent results after sensitivity analysis.CONCLUSION Vonorasan diathermy can be used as an alternative to PPI duotherapy,with lower costs and economic advantages compared to rabeprazole and esomeprazole duotherapy.