【摘要】 目的:探讨四种口服抗瘢癎药单药治疗1年的成本和效果。方法:将266例癫癎病人随机分成四个组:卡马西平组47例,服用卡马西平900～1 200 mg/d;德巴金组59例,服用德巴金500～1500 mg/d;妥泰组87例.服用妥泰100～150 mg/d;拉莫三嗪组73例,服用拉莫三嗪75～150 mg/d;均进行单药治疗,疗程均为1年。运用成本-效果分析对四组病人进行分析评价。结果:卡马西平、德巴金、妥泰、拉莫三嗪四组完成疗程病例数分别为41,55,79和71例。在疗程结束时,四组有效率分别为73.1%、89.1%、91.1%和98.5%,拉莫三嗪组疗效显著高于其他三组（P<0.05）,不良反应率也显著低于其他三组（P<0.01）。四组总成本分别为1503.9±250.6、3122.1±520.3、2539.4±507.2、3703.6±740.7元/年·例^-1;成本-效果比即100%有效的每例费用（治愈成本）分别为2057.1±347.4、3655.8±601.2、2787.4±513.8、3760.0±757.3元。经敏感度分析后的成本-效果比分别为2009.0±398.5、3165.1±627.3、2295.7±564.7、3102.9±768.1元。结论:卡马西平、德巴金、妥泰、拉莫三嗪均有较好的抗癫癎效果。在经济许可的情况下,偏重考虑药物安全性和依从性.拉莫三嗪是较佳选择。更多还原

【Abstract】 Objective:To evaluate the cost and efficacy of 4 anti-epilepsy drugs for 1 year’s treat- ment in patients with epilepsy.Methods.266 patients were randomly divided into 4 groups:47 patients of the carbamazapine(CBZ)group took CBZ 900～1200 mg/d;59 patients of the depakine(DPK)group took DPK 500～1500 mg/d,87 patients of the topiramate(TPM)group took TPM 100～150 mg/d;73 patients of the lamotrigine(LTG)group took LTG 75～150 mg/d.The treatment lasted 1 year.Cost effectiveness analysis was used to evaluate the cost and efficacy of the 4 groups.Results:There were 41, 55,79,and 71 patients who completed the study in CBZ group,DPK group,TPM group and LTG group respectively.There was significant difference in the clinical efficacy of the four groups(P<0.05)at the end of the study.The adverse reaction rate of LTG group was significantly lower than that of the other 3 groups(P<0.01).The total cost of 4 groups was$1503.9±250.6,3122.1±520.3,2539.4±507.2 and 3703.6±740.7 respectively.The cost effectiveness ratios of curing per-patients were$2057.1±347.4,3655.8±601.2,2787.4±513.8 and 3760.0±757.3 respectively,and became$2009.0±398.5, 3165.1±627.3,2295.7±564.7 and 3102.9±768.1 after sensitivity analysis.Conclusions:CBZ is an in- expensive and effective drug for epilepsy.If budget allows,and considering drug safety,LTG is also anappropriate choice.更多还原