目的 系统评价泮托拉唑与雷尼替丁比较治疗十二指肠溃疡的有效性和安全性,并分析其药物经济性。方法 计算机检索PubMed、Medline、EMbase、The Cochrane Library、CNKI、VIP和WanFang Data,查找有关口服用泮托拉唑与雷尼替丁比较治疗十二指肠溃疡的随机对照试验(RCT),检索时间均为从建库至2014年9月。由2位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.2软件进行Meta分析,并以决策树模型进行成本-效果分析。结果 共纳入6个RCT,包括患者1 225例。Meta分析结果显示:2周和4周溃疡治愈率,泮托拉唑均优于雷尼替丁;2周疼痛症状缓解率,泮托拉唑优于雷尼替丁;2周胃肠道症状缓解率,泮托拉唑优于雷尼替丁;不良反应发生率,泮托拉唑与雷尼替丁相当;成本-效果比,雷尼替丁优于泮托拉唑(29.33 vs 53.90)。结论 现有证据表明,泮托拉唑为治疗十二指肠溃疡较为有效的方案,雷尼替丁为较为经济的方案,而两者安全性相当且耐受性较好,可根据患者实际情况进行个体化选择。
Abstract
OBJECTIVE To systematically review the effectiveness and safety of pantoprazole in comparison with ranitidine for patients with duodenal ulcer, and evaluate the cost of the two drugs. METHODS PubMed, Medline, EMbase, the Cochrane Library and three Chinese literature databases (VIP, CNKI and WanFang) were searched. Randomized controlled trials(RCTs) that compared the clinical outcomes of pantoprazole (PAN) group vs. ranitidine(RAN) group for duodenal ulcer were included. Two reviewers independently screened literature in accordance with the inclusion and exclusion criteria, extracted the data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software and cost-effectiveness analysis was performed with the decision tree model. RESULTS A total of six RCTs involving 1 225 patients were included. The results of meta-analysis showed that PAN was superior to RAN in the 2-week or 4-week ulcers healing rates . Compared with RAN groups, PAN group had significantly higher rates of pain and gastrointestinal symptoms relief. While there was no significant difference in the incidence of adverse events between the PAN and the RAN groups . And the cost-effectiveness ratio was lower in the RAN group than in the PAN group(29.33 vs 53.90). CONCLUSION Current evidence indicates that, pantoprazole is an effective scheme for duodenal ulcer, and ranitidine is considered as an economic choice. Both treatments are safe and well tolerated.
关键词
泮托拉唑 /
雷尼替丁 /
十二指肠溃疡 /
药物经济学 /
系统评价 /
Meta分析 /
随机对照试验
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Key words
pantoprazole /
ranitidine /
duodenal ulcer /
pharmacoeconomics /
systematic review /
Meta-analysis /
randomized controlled trial
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中图分类号：
R969.3
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参考文献
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脚注
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基金
十二五国家科技支撑计划课题资助项目(2013BAI06B04)
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