3种用药方案治疗甲状腺功能亢进的药物经济学评价
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摘要
目的:评价3种用药方案治疗甲状腺功能亢进的经济性。方法:收集我院2016年全年诊疗的564例甲状腺功能亢进门诊患者的病历资料,按照用药方案分成A组(185例)、B组(191例)和C组(188例)。A组患者口服甲巯咪唑片2~4片,每天1次,视病情逐渐减量至0.5~2片;B组患者口服甲巯咪唑片(用法用量同A组)+抑亢丸6 g,每天2次;C组患者口服甲巯咪唑片(用法用量同A组)+夏枯草片6片,每天2次。3组患者疗程均为10个月。观察3组患者临床疗效、不良反应发生情况和复发情况,并运用药物经济学的成本-效果分析法对3种治疗方案进行经济学评价。结果:A、B、C组的总有效率分别为94.06%、95.29%、95.75%,总不良反应发生率分别为11.36%、10.48%、10.11%,差异均无统计学意义(P>0.05),3组患者均未出现复发情况。3组患者人均成本分别为633.80、3 548.89、3 596.00元,A组成本最低。敏感度分析结果显示亦为A组成本最低。结论:3种用药方案治疗甲状腺功能亢进的疗效与安全性均较好,其中甲巯咪唑单用方案具有较高的经济性。
OBJECTIVE:To evaluate the economical efficiency of 3 therapeutic regimens for hyperthyroidism. METHODS:Medical records of 564 hyperthyroid outpatients were selected from our hospital in 2016,and they were divided into group A(185 cases),group B(191 cases)and group C(188 cases)according to drug use. Group A received Thiamazole tablets 2-4 tablet,once asthecondition gradually reduce th amount to 0.5-2 tablets orally;group B received Thiamazole tablets(cusage and dosage are the same as group A)+Yikang pills 6 g,bid orally;group C received Thiamazole tablets(cusage and dosage are the same as group A)+Xiakucao tablets 6 tablets,bid orally. The treatment courses of 3 groups lasted for 10 months. Clinical efficacy the occurrence of ADR and recurrence were observed in 3 groups.The pharmacoeconomic cost-effectiveness analysis was adopted for the economic evaluation of 3 therapeutic regimens. RESULTS:The tolal response rates of group A,B,C were 94.06%,95.29%,95.75%,respectively;total incidence of ADR were 11.36%,10.48%,10.11%;there was no statistical significance(P>0.05). No recurrence occurred in the 3 groups. The average cost of 3 groups were 633.80,3 548.89,3 596.00 yuan,respectively. The cost of group A was the lowest. The results of sensitivity analysis were also that the cost of group A was the lowest. CONCLUSIONS:3 therapeutic regimens show good therapeutic efficacy and safety for hyperthyroidism,among which thiamazole alone has relatively higher pharmacoeconomic significance.
OBJECTIVE:To evaluate the economical efficiency of 3 therapeutic regimens for hyperthyroidism. METHODS:Medical records of 564 hyperthyroid outpatients were selected from our hospital in 2016,and they were divided into group A(185 cases),group B(191 cases)and group C(188 cases)according to drug use. Group A received Thiamazole tablets 2-4 tablet,once asthecondition gradually reduce th amount to 0.5-2 tablets orally;group B received Thiamazole tablets(cusage and dosage are the same as group A)+Yikang pills 6 g,bid orally;group C received Thiamazole tablets(cusage and dosage are the same as group A)+Xiakucao tablets 6 tablets,bid orally. The treatment courses of 3 groups lasted for 10 months. Clinical efficacy the occurrence of ADR and recurrence were observed in 3 groups.The pharmacoeconomic cost-effectiveness analysis was adopted for the economic evaluation of 3 therapeutic regimens. RESULTS:The tolal response rates of group A,B,C were 94.06%,95.29%,95.75%,respectively;total incidence of ADR were 11.36%,10.48%,10.11%;there was no statistical significance(P>0.05). No recurrence occurred in the 3 groups. The average cost of 3 groups were 633.80,3 548.89,3 596.00 yuan,respectively. The cost of group A was the lowest. The results of sensitivity analysis were also that the cost of group A was the lowest. CONCLUSIONS:3 therapeutic regimens show good therapeutic efficacy and safety for hyperthyroidism,among which thiamazole alone has relatively higher pharmacoeconomic significance.
引文
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[10]柏蓉.3种不同他汀类药物治疗高血脂症的成本-效果分析[J].中国药房,2015,26(26):3620-3622.
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[2]廖戮缪,蒙碧辉,陆丽莹.甲巯咪唑与丙硫氧嘧啶对甲状腺功能亢进症肝功能影响的比较[J].广东医学,2014,35(8):1249-1251.
[3]殷智晔.夏枯草颗粒联合甲巯咪唑片治疗弥漫性甲状腺肿伴甲状腺功能亢进的疗效观察[J].现代药物与临床,2016,31(1):70-74.
[4]邓红玲,张金红.131I治疗甲状腺功能亢进症的临床观察[J].河北医药,2014,8(20):3103-3105.
[5]向建军.中西医结合治疗甲状腺功能亢进症临床疗效观察[J].湖北中医杂志,2014,14(7):9-10.
[6]金美娟,王健,李进,等.中西医结合治疗甲状腺功能亢进症疗效观察[J].浙江中医杂志,2011,46(9):659-660.
[7]王素莉,姥勇,张秀琴,等.清肝消瘿方结合西医常规疗法治疗甲亢的疗效观察[J].中药材,2015,38(2):425-427.
[8]董翠红.调肝泻火汤联合小剂量他巴唑治疗甲亢60例疗效观察[J].山东医药,2011,51(49):40.
[9]林玉燕,吴春光,李汉荣,等.小剂量甲巯咪唑联合加味知柏地黄汤治疗甲状腺功能亢进的成本及疗效分析[J].中国药业,2015,24(13):21-22.
[10]柏蓉.3种不同他汀类药物治疗高血脂症的成本-效果分析[J].中国药房,2015,26(26):3620-3622.
[11]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:686-687.
[12]中华医学会内分泌学分会.中国甲状腺疾病诊治指南:甲状腺功能亢进症[J].中华内科杂志,2007,46(10):876-882.