含呋喃唑酮短程三联及四联药物治疗幽门螺杆菌感染成本效果分析

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Clinical cost-effectiveness analysis on eradication of H. Pylori using regiment of one-week quadruple and triple therapy

Aim To evaluate the efficacy and cost-effectiveness of one-week regiment of quadruple and triple therapy containing:Lansoprazle(L),colloidal bismuth subciteate(B),amoxicillin(A),metrnidozole(M) and furazolidone(F).Methods 227 patients with duodenal ulcer(DU) or non-ulcer dyspepsia (NUD) confirmed by endoscopy were received LAFB,LAM or LAF,twice daily for 7 days.Endoscopy was performed in DU and 14 C-UBT was performed in NUD 4 weeks after completion of treatment.Results (1)The eradication rate of H.pylori by LAFB,LAM and LAF were 96.30%,84.51% and 70.59% respectively(LAFB vs LAF and LAF,P<0.05;LAFB vs LAM P<0.01).The healing rate of DU had no difference between three regiment P<0.05).The cost-effectiveness analysis on eradication of H.pylori showed that cost/effectiveness (C/E) of LAFB is the lowest.(2)The healing rate of DU ulcer in H.pylori eradicated patients was higher than that in uneradicated ones(98.94% vs 50%,P<0.01).The rate of ulcer recurrent of year was lower in H.pylori eradicated patients than that in uneradicated patients(2.15% vs 71.42%,P<0.01).(3)The rate of relieving symptom and recurrenting symptom in one year had no difference between H.pylori eradicated patients and uneradicated patiens in NUD(71.74% vs 70% and 53.03 vs 50,P>0.05).Conclusions The efficacy of one week regiment of quadruple therapy is higher than that in triple therapy but the side effect was not higher.The higher eradication rate is caused by combination of furazolidone,bacause it is low resis tant to H.pylori.It is also a cost-saving strategy.Eradication of H.pylori infection could improve ulcer healing and decrease the rate of ulcer recurrent but is not likely to relieve symptomes in NUD patients.