Jensen D M
Am J Med. 1984 Nov 19;77(5B):8-14.
The costs to society of peptic ulcer disease have become exorbitant. These costs are incurred either directly (hospitalization, physician care, and medication costs) or indirectly (loss of productivity due to absenteeism, the loss to society of functioning persons or death of productive persons). Although the results of many studies show that hospitalization for duodenal ulcer disease has decreased, the incidence of perforation, which may be a better index of the disease, has not changed significantly. For many patients and for society, peptic ulceration is a chronic and costly disease. The cost effectiveness of the available treatment modalities are variable and dependent on preventing recurrence. Medical treatment, including the use of antacids and the newer H2-receptor antagonists, seems to be promising. Cimetidine, for example, is effective in treating the acute stage of the disease, but some studies have shown that once the treatment period is over, the ulcers tend to recur. Ranitidine, a newer H2-receptor antagonist, is as effective as cimetidine for healing peptic ulcers and may be more useful as long-term therapy to prevent recurrences. If so, costs to society of this disease can be greatly reduced.
消化性溃疡疾病给社会带来的成本已经变得过高。这些成本要么是直接产生的（住院费、医生诊疗费和药费），要么是间接产生的（因旷工导致的生产力损失、社会中功能健全人员的损失或有生产力人员的死亡）。尽管许多研究结果表明十二指肠溃疡疾病的住院率有所下降，但穿孔发生率（这可能是该疾病更好的指标）并未显著改变。对许多患者和社会而言，消化性溃疡是一种慢性且代价高昂的疾病。现有治疗方式的成本效益各不相同，且取决于预防复发情况。药物治疗，包括使用抗酸剂和更新的H2受体拮抗剂，似乎很有前景。例如，西咪替丁对治疗该疾病的急性期有效，但一些研究表明，一旦治疗期结束，溃疡往往会复发。雷尼替丁是一种更新的H2受体拮抗剂，在治愈消化性溃疡方面与西咪替丁一样有效，并且作为预防复发的长期疗法可能更有用。如果是这样，这种疾病给社会带来的成本可以大幅降低。
