5 种质子泵抑制剂联合健胃愈疡胶囊治疗消化性溃疡的成本- 效果分析

Cost-effectiveness analysis of five proton pump inhibitors with Jianweiyuyang capsules for peptic ulcer

摘要:

目的 探讨5 种质子泵抑制剂分别联合健胃愈疡胶囊治疗幽门螺杆菌（Hp）阳性消化性溃疡的成本—效果及长期疗效。方法 275 例Hp 阳性消化性溃疡患者按照随机数字表分为奥美拉唑组（A 组），雷贝拉唑（B 组）、泮托拉唑（C 组）、兰索拉唑（D 组）以及埃索美拉唑（E 组），每组55 例。观察不同组别的成本/ 效果比（C/E）、增量成本/ 效果比（△ C/ △ E）、敏感性分析效果以及随访1 年后的长期疗效。结果 成本- 效果分析及敏感性分析结果显示B 组C/E 最低，E 组△ C/ △ E 最高；随访1 年结果显示，A、B、C、D、E 组HP 再次感染率分别为83.7%、41.3%、85.5%、64.5% 和61.4%，溃疡复发率分别为2.05%、0.48%、2.61%、1.18% 和1.07%，组间比较差异有统计学意义（P <0.05），其中B 组低于A、C 及E 组（P <0.05），而B 组与D 组比较差异无统计学意义（P >0.05）。结论 雷贝拉唑联合健胃愈疡胶囊在治疗HP 阳性消化性溃疡的成本- 效果及长期疗效优于其他各组，为最佳治疗方案，临床上值得推广。

Abstract:

Objective To evaluate the cost-effectiveness and long-term efficacy of 5 proton pump inhibitors combined with Jianweiyuyang capsules for H. pylori-positive peptic ulcer. Methods A total of 275 patients with H. pylori-positive peptic ulcer were randomly divided into Omeprazole group (group A), Rabeprazole group (group B), Pantoprazole group (group C), Lansoprazole group (group D) and Esomeprazole group (group E). The costeffectiveness ratio (C/E), incremental cost-effectiveness ratio ( △ C/ △ E), sensitivity analysis and long-term efficacy after 1-year follow-up were surveyed. Results Cost-effectiveness analysis and sensitivity analysis showed that the group B had the lowest C/E, the group E had the highest △ C/ △ E. After 1-year follow-up, the H. pylori reinfection rates of the groups A, B, C, D, E were 83.7%, 41.3%, 85.5%, 64.5% and 61.4% respectively; the ulcer recurrence rates were 2.05%, 0.48%, 2.61%, 1.18% and 1.07% respectively, there were statistically significant differences between the groups (P < 0.05); the two rates in the group B were significantly lower than those in the groups A, C, E (P < 0.05),but there were no significant differences between the group B and the group D (P > 0.05). Conclusions Costeffectiveness and long-term efficacy of Rabeprazole combined with Jianweiyuyang capsule are better than other proton pump inhibitors for H. pylori-positive peptic ulcer. It should be the best option in clinical practice.