治疗肠易激综合征药物的成本—效果分析

Cost - Effectiveness Analysis of Drugs on Irritable Bowel Syndrome

目的 对双歧三联活菌、盐酸帕罗西汀和匹维溴铵三种药物进行成本—效果分析(CEA),为肠易激综合征(IBS)治疗的合理用药提供科学依据。方法 301例符合罗马Ⅱ标准的IBS患者入选本试验,经2周适应期后280例患者被随机分配至双歧三联活菌、盐酸帕罗西汀及匹维溴铵治疗组,研究开始即每2周对腹痛、腹胀等临床症状进行评分,观察12周,在试验结束时进行CEA评估。结果 在缓解IBS患者的腹痛方面,盐酸帕罗西汀组疗效及成本一效果分析最佳;在缓解IBS患者的腹胀和排便紊乱方面,双歧三联活菌组疗效及成本一效果分析最佳。结论以腹痛为主的IBS患者,小剂量的盐酸帕罗西汀为较佳的临床选择;以腹胀或排便紊乱为主的IBS患者,双歧三联活菌为较佳的临床选择。

Objective Try to provide scientific basis for medication in clinical treatment of irritable bowel syndrome ( IBS ) , through the cost - effectiveness analysis ( CEA ) of bifid, paroxetine hydrochloride and pinaverium bromide, three common drugsused in the treatment of IBS. Methods Three hundred and one IBS patients diagnosed according to Rome Ⅱ diagnostic criteria were enrolled in the study. After a 2 -week run -in,280 patients were randomly assigned to three treatment groups;each receiving bifid,paroxetine hydrochloride and pinaverium bromide respectively for 12 weeks. At the beginning of the study and thereafter every 2 weeks abdominal pain/discomfort, abdominal distention and other symptoms were scored. CEA was done at the end of the study. Results Paroxetine hydrochloride was the best of the three groups in relieving abdominal pain/discomfort of IBS in efficacy and CEA while bifid was the best of the three groups in abdominal distention and defecation derangement of IBS. Conclusion A low - dose paroxetine hydrochloride may be preferable in pain - predominant patients and bifid may be an excellent choice in distention - predominant and disturbed defecation - predominant IBS patients.