艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价

李国栋; 许亚; 朱颖; 常宁

doi:10.14009/j.issn.1672-2124.2020.11.020

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艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价

用药评价 | 更新时间：2022-10-08

- 艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价
- Systematic Review of Esomeprazole and Omeprazole in the Treatment of Duodenal Ulcer
- 中国医院用药评价与分析 2020年20卷第11期页码：1359-1364
- 作者机构：
  
  徐州市中心医院药剂科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2020.11.020
  中图分类号： R573.1
- 纸质出版日期：2020，
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[1]李国栋,许亚,朱颖,常宁.艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价[J].中国医院用药评价与分析,2020,20(11):1359-1364.

LI Guodong, XU Ya, ZHU Ying, et al. Systematic Review of Esomeprazole and Omeprazole in the Treatment of Duodenal Ulcer[J]. 2020,20(11):1359-1364.
[1]李国栋,许亚,朱颖,常宁.艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统评价[J].中国医院用药评价与分析,2020,20(11):1359-1364. DOI： 10.14009/j.issn.1672-2124.2020.11.020.

LI Guodong, XU Ya, ZHU Ying, et al. Systematic Review of Esomeprazole and Omeprazole in the Treatment of Duodenal Ulcer[J]. 2020,20(11):1359-1364. DOI： 10.14009/j.issn.1672-2124.2020.11.020.

摘要

目的:通过艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的系统分析

对其有效性、安全性及经济性进行评价。方法:计算机检索Pub Med、Cochrane图书馆、外文医学信息资源检索平台、万方数据库、中国期刊全文数据库、中国生物医学文献数据库和中文科技期刊全文数据库等数据库中所有关于艾司奥美拉唑与奥美拉唑治疗十二指肠溃疡的相关文献（研究组干预措施为艾司奥美拉唑

对照组干预措施为奥美拉唑）

参照纳入、排除标准进行文献筛选

在文献质量评估及其特征描述之后

采用Rev Man 5.2统计软件对文献统计的数据进行荟萃分析（Meta分析）

并进行成本-效果分析。结果:纳入10篇文献

均为随机对照试验

共计638例患者。Meta分析结果显示

艾司奥美拉唑治疗十二指肠溃疡或十二指肠溃疡伴出血的总有效率与奥美拉唑基本相当（OR=2.82

95%CI=0.98～8.16

P=0.06; OR=3.36

95%CI=0.95～11.92

P=0.06）;艾司奥美拉唑的4周溃疡治愈率明显优于奥美拉唑（OR=2.04

95%CI=1.14～3.67

P=0.02）

艾司奥美拉唑1 d、3 d内缓解疼痛症状的效果较奥美拉唑更明显（OR=2.83

95%CI=1.74～4.62

P <0.000 1; OR=3.21

95%CI=1.16～8.84

P=0.02）

但两者7 d内缓解疼痛的效果基本相当（OR=1.83

95%CI=0.91～3.68

P=0.09）;艾司奥美拉唑的止血时间明显短于奥美拉唑（SMD=-1.82

95%CI=-2.28～-1.36

P<0.000 01）;艾司奥美拉唑的不良反应发生率明显低于奥美拉唑（OR=0.28

95%CI=0.14～0.55

P=0.000 3）。但成本-效果分析结果显示

奥美拉唑较艾司奥美拉唑更具药物经济学优势。结论:艾司奥美拉唑治疗十二指肠溃疡的短期疗效优于奥美拉唑

长期疗效方面两者基本相当。本研究中临床用药病例的样本量可能较少并且所纳入的文献质量一般

因此

要获得更具代表性且更加严谨的研究结果

后续研究可作进一步的验证。

Abstract

OBJECTIVE: To systematically evaluate the efficacy

safety and economy of esomeprazole and omeprazole in the treatment of duodenal ulcer. METHODS: PubMed

the Cochrane Library

FMRS

Wanfang Database

CNKI

CBM and Chinese Science and Technology Journal Full-Text Database were retrieved for literature of esomeprazole and omeprazole in the treatment of duodenal ulcer（ the intervention was esomeprazole in the study group and omeprazole in the control group）. Literature were screened by referring to inclusion and exclusion criteria

and after literature quality assessment and feature description

the RevMan 5. 2 statistical software was used for Metaanalysis of literature statistical data and cost-effectiveness analysis. RESULTS: Ten randomized controlled trials（ RCT） were collected

including 638 patients. Meta-analysis results showed that the total effective rate of esomeprazole in the treatment of duodenal ulcer or duodenal ulcer with bleeding was basically the same as that of omeprazole（ OR = 2. 82

95% CI = 0. 98-8. 16

P = 0. 06; OR = 3. 36

95% CI = 0. 95-11. 92

P = 0. 06）. The four-week cure rate of ulcer of esomeprazole was significantly better than that of omeprazole（ OR = 2. 04

95% CI = 1. 14-3. 67

P= 0. 02）

and the pain relief effect of esomeprazole was more significant than that of omeprazole within 1 d and 3 d（ OR = 2. 83

95% CI = 1. 74-4. 62

P < 0. 000 1; OR = 3. 21

95% CI = 1. 16-8. 84

P = 0. 02）

but the pain relief effect of the two within 7 d was basically the same（ OR = 1. 83

95% CI = 0. 91-3. 68

P = 0. 09）. The hemostasis time of esomeprazole was significantly shorter than that of omeprazole（ SMD =-1. 82

95% CI =-2. 28--1. 36

P < 0. 00001）. The incidence of adverse drug reactions of esomeprazole was significantly lower than that of omeprazole（ OR =0. 28

95% CI = 0. 14-0. 55

P = 0. 000 3）. However

cost-effectiveness analysis showed that omeprazole had an advantage over esomeprazole. CONCLUSIONS: The short-term efficacy of esomeprazole in the treatment of duodenal ulcer is better than that of omeprazole

and the long-term efficacy of the two is basically the same. The sample size of clinical drug cases in this study is relatively small and the included literature are of average quality. Therefore

followup studies can be further verified by obtaining more representative and rigorous research results.

关键词

艾司奥美拉唑奥美拉唑十二指肠溃疡药物经济学Meta分析

Keywords

EsomeprazoleOmeprazoleDuodenal ulcerPharmacoeconomicsMeta-analysis

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