【摘要】 目的 评价五种不同药物治疗子宫内膜异位症的疗效和成本，为不同情况的患者推荐适用的治疗方案。方法 回顾性分析某院子宫内膜异位症患者共135例，分为五组：达菲林组、诺雷得组、抑那通组、散结镇痛胶囊组、孕三烯酮组。比较五组患者成本-效果比和不良反应的差异。结果 五组方案6个月治疗成本分别为7 680.00、10 081.23、9 596.47、2 487.74、978.00元，总有效率分别为95.45%、94.44%、94.00%、86.46%、90.90%。成本-效果比分别为8 046.10、11 659.99、10 161.45、2 736.79、1 040.43。不良反应方面，散结镇痛胶囊消化道症状明显，需考虑胃病患者避免使用；抑那通会使糖尿患者使用期间出现血糖升高、骨密度下降，糖尿病和老年女性患者需慎用；达菲林、诺雷得、抑那通价格最贵，但是由于其疗效好，不良反应较小，依从性好，因此是子宫内膜异位症手术之后巩固治疗的可选择药物，特别是对于经济条件较好的患者，可作为首选药物；孕三烯酮因为价格较低廉，疗效也好，不良反应小，也是不错的选择，可以作为经济条件一般对药物价格较为敏感患者的首选药物，同时注意特殊不良反应的针对性人群。结论 五种治疗方案，孕三烯酮组疗效较高，成本-效果比最低；五种治疗方案的6个月治疗成本比较中，孕三烯酮6个月治疗成本为978.00元，是处于医保范围内的适用药物的最低水平。在成本-效果比较低的几类药物中，孕三烯酮疗效好，因此对于大部分患者，孕三烯酮每周2次的依从性更好，且不良反应低、价格低廉、医保报销，临床更推荐孕三烯酮作为该类患者的常用治疗药物。更多还原

【Abstract】 Objective To evaluate the efficacy and cost of five different drugs in the treatment of endometriosis and to recommend appropriate treatment options for patients with different conditions. Methods A total of 135 patients with endometriosis in our hospital were retrospectively analyzed and divided into 5 groups: diphereline group, zoladex group, enantone group, Sanjiezhentong Capsule group and gestrinone group. The differences in cost-effectiveness ratios and adverse effects were compared among the five groups of patients. Results The 6-month treatment costs of the five groups were 7 680.00, 10 081.23, 9 596.47, 2 487.74 and 978.00 yuan, respectively, and the total effective rates were 95.45%, 94.44%, 94.00%, 86.46% and 90.90%, respectively. The cost-effectiveness ratios were 8 046.10 and 11 659.99, 10 161.45, 2 736.79, 1 040.43,respectively.In terms of adverse reactions, Sanjiezhentong Capsules have obvious gastrointestinal symptoms and should be considered to avoid use in patients with gastropathy. Enantone may increase blood glucose and decrease bone mineral density in diabetic patients during use, and should be used with caution in diabetic and elderly female patients. Diphereline, zoladex and enantone are the most expensive drugs. However, due to their good efficacy, less side effects and good compliance, they are the optional drugs for consolidation therapy after endometriosis surgery, especially for patients with better economic conditions, which can be used as the first choice; gestrinone is also a good choice because of its low price, good efficacy and less side effects, which can be used as the first choice for patients with economic conditions who are generally more sensitive to drug prices, and attention should be paid to the targeted population with special adverse reactions. Conclusion Among the five treatment regimens, gestrinone group had the highest efficacy and the lowest cost-effectiveness ratio. The 6-month treatment cost of gestrinone was 978.00 yuan, which was the lowest level of applicable drugs covered by medical insurance. Among the several classes of drugs with relatively low cost-effectiveness, gestrinone has good efficacy, so for most patient populations, gestrinone twice a week has better compliance, low adverse reactions, low price, and medical insurance reimbursement, and gestrinone is more recommended as a commonly used treatment for such patients in clinical practice.更多还原