摘要
目的探讨富马酸伏诺拉生和奥美拉唑治疗胃食管反流病的成本-效果,为临床合理选择药物提供参考。方法选取2021年2月至2024年1月于上海交通大学医学院附属瑞金医院消化内科确诊并接受治疗的137例胃食管反流病患者,经数字表法随机分为两组,伏诺拉生组69例患者接受富马酸伏诺拉生片治疗,奥美拉唑组68例患者接受奥美拉唑肠溶片治疗。比较两组患者的治疗效果、临床症状缓解时间、肠胃激素水平、不良反应发生情况及成本-效果比。结果伏诺拉生组治疗有效率为91.30%(63/69)高于奥美拉唑组的77.94%(53/68)(χ^(2)=4.712,P<0.05);伏诺拉生组反流、烧灼感、腹痛、嗳气等临床症状缓解时间[分别为(10.23±2.54)d、(11.57±2.39)d、(12.82±2.48)d、(13.14±2.72)d]均短于奥美拉唑组[分别为(13.51±3.16)d、(14.23±2.85)d、(15.56±3.07)d、(17.35±3.56)d](t=6.701、5.923、5.750、7.785,均P<0.05)。治疗后,患者血管活性肠肽水平,伏诺拉生组[(42.49±6.22)pg·mL^(-1)],较奥美拉唑组[(47.52±6.90)pg·mL^(-1)]降低;胃动素、胃泌素水平,伏诺拉生组[分别为(243.36±16.43)pg·mL^(-1)、(55.83±7.84)pg·mL^(-1)],较奥美拉唑组[分别为(232.93±17.15)pg·mL^(-1)、(50.79±7.51)pg·mL^(-1)]升高,差异有统计学意义(t=4.483、3.635、3.842,均P<0.05)。不良反应总发生率伏诺拉生组13.04%(9/69)与奥美拉唑组16.81%(11/68)比较,差异无统计学意义(χ^(2)=0.270,P>0.05)。成本-效果分析,LA分级中A级、B级和C级的胃食管反流病患者应用富马酸伏诺拉生治疗的成本-效果比均低于应用奥美拉唑治疗(U=45.315,32.697,69.624;均P<0.05);治疗效果中有效、显效和痊愈的胃食管反流病患者应用富马酸伏诺拉生治疗的成本-效果比均低于应用奥美拉唑治疗(U=52.314,39.687,59.487;均P<0.05)。结论富马酸伏诺拉生治疗胃食管反流病患者在疗效、临床症状缓解时间及肠胃激素水平等方面均优于奥美拉唑,且成本-效果比更好。
Objective To investigate the cost-effectiveness of volnoxan fumarate and omeprazole in the treatment of gastroesophageal reflux(GERD)to provide a reference for the rational selection of drugs in the clinic.Methods One hundred and thirty-seven patients with GERD admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2021 to January 2024 were selected and randomly divided into two groups:69 patients in the vonorasan group were treated with vonorasan fumarate tablets,and 68 patients in the omeprazole group were treated with omeprazole enteric-coated tablets.The treatment effects,time to clinical symptom relief,gastrointestinal hormone levels,incidence of adverse effects and cost-effectiveness ratios were compared between the two groups.Results The treatment effectiveness rate of 94.20%(65/69)in the vonorasan group was higher than 82.35%(56/68)in the omeprazole group(χ^(2)=4.712,P<0.05).The time for clinical symptoms such as reflux,heartburn,abdominal pain,belching and other clinical symptoms to be relieved was shorter in the voronasan group((10.23±2.54)d,(11.57±2.39)d,(12.82±2.48)d,(13.14±2.72)d,respectively)than that in the omeprazole group((13.51±3.16)d,(14.23±2.85)d,(15.56±3.07)d,(17.35±3.56)d)(t=6.701,5.923,5.750,7.785,all P<0.05).After treatment,vasoactive intestinal peptide(VIP)level((42.49±6.22)pg·mL^(-1))was decreased,and gastrin(MTL)and gastrin(GAS)levels((243.36±16.43)pg·mL^(-1),(55.83±7.84)pg·mL^(-1),respectively)were elevated in the voronasan group,which were higher than those in the omeprazole group((47.52±6.90)pg·mL^(-1),(232.93±17.15)pg·mL^(-1),(50.79±7.51)pg·mL^(-1))(t=4.483,3.635,3.842,all P<0.05).In terms of adverse reactions,the overall incidence of 13.04%(9/69)in the vonorasan group was not significantly different from that of 16.81%(11/68)in the omeprazole group(χ^(2)=0.270,P>0.05).In the cost-effectiveness analysis,the cost-effectiveness ratios of patients with GERD classified as LA grade A,B,and C treated with vonoprazan were all lower than those treated with omeprazole(U=45.315,32.697,69.624;all P<0.05).Among GERD patients with effective,marked and complete responses to treatment,the cost-effectiveness ratios of those treated with vonoprazan were also lower than those treated with omeprazole(U=52.314,39.687,59.487;all P<0.05).Conclusion The treatment of patients with GERD using volnoxan fumarate is superior to that using omeprazole in terms of therapeutic efficacy,time to clinical symptom relief and gastrointestinal hormone levels,and is more cost-effective.
作者
胡丽秀
林城江
徐蕾
吕梁嬿
Hu Li-xiu;Lin Cheng-jiang;Xu Lei;Lyu Liang-yan(Department of Pharmacy,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200020,China)
出处
《中国药物应用与监测》
2025年第1期153-157,共5页
Chinese Journal of Drug Application and Monitoring
关键词
富马酸伏诺拉生
奥美拉唑
胃食管反流病
疗效
成本-效果比
Vonoprazan fumarate
Omeprazole
Gastrooesophageal reflux disease
Efficacy
Cost-effectiveness ratio
