Chen S Y, Wang J Y, Zhang X D, Zhang S S
Shi-Yao Chen, Ji-Yao Wang, Jie-Chen, Xi-De Zhang, Shan-Shen Zhang, Department of Gastroenterology, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
World J Gastroenterol. 1997 Sep 15;3(3):194. doi: 10.3748/wjg.v3.i3.194.
To compare the efficiency of therapy with a 2-week regimen of amoxicillin plus metronidazole and six weeks of Tagamet (AMT group) vs the efficacy of therapy with 6 wk of omeprazole plus 2 wk of amoxicillin (OA group) for ulcer healing, Helicobacter pylori (Hp) eradication, and decreasing the recurrence of duodenal ulcers.
This cost-effectiveness analysis was based on results shown in a randomized controlled trial conducted in 1995 in patients with a duodenal ulcer (OA group, 46 patients; AMT group, 43 patients) and treated at class grade III A hospitals in Shanghai, China.
The costs of treatment in the AMT group were less than those in the OA group for ulcer healing (￥546.25 vs ￥1296.76 per case, P < 0.01), Hp eradication (￥702.32 vs ￥1742.53 per case, P < 0.01), and decreasing ulcer recurrence (￥640.39 vs 1424.54 per case, P < 0.01). Direct costs comprised the major cost involved in treatment of duodenal ulcers. The difference in the cost of treating ulcers in the two groups was primarily due to the costs of the different drugs. There was no significant difference between the two groups regarding their direct non-medical costs and indirect costs.
When based on therapeutic effectiveness and financial costs, AMT therapy was more cost-efficient than OA therapy. AMT therapy is recommended for its low cost, acceptable ulcer healing rates, ability to cure of an Hp infection, and especially when treating patients with an ulcer < 1 cm in diameter.
比较阿莫西林联合甲硝唑2周疗法加泰胃美6周疗法（AMT组）与奥美拉唑6周疗法加阿莫西林2周疗法（OA组）在溃疡愈合、根除幽门螺杆菌（Hp）及降低十二指肠溃疡复发率方面的治疗效果。
本成本效益分析基于1995年在中国上海三级甲等医院对十二指肠溃疡患者进行的一项随机对照试验结果（OA组46例患者；AMT组43例患者）。
AMT组在溃疡愈合（每例546.25元 vs 1296.76元，P < 0.01）、根除Hp（每例702.32元 vs 1742.53元，P < 0.01）及降低溃疡复发率（每例640.39元 vs 1424.54元，P < 0.01）方面的治疗成本均低于OA组。直接成本是十二指肠溃疡治疗的主要成本。两组治疗溃疡成本的差异主要源于不同药物的成本。两组在直接非医疗成本和间接成本方面无显著差异。
基于治疗效果和经济成本，AMT疗法比OA疗法更具成本效益。AMT疗法因其成本低、溃疡愈合率可接受、能治愈Hp感染，尤其适用于治疗直径<1 cm的溃疡患者，故推荐使用。
