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  本文選題：頭孢曲松 + 蘭索拉唑　； 參考：《山東中醫(yī)藥大學》2014年碩士論文

【摘要】：目的：通過搜集查閱頭孢曲松、蘭索拉唑、美羅培南藥品說明書，國內外主要數據庫相關文獻，進行篩選整理，對其上市以來的臨床療效、經濟學等方面進行總結歸納并建立綜合評價資料，以期為臨床合理用藥提供依據。 方法：1.Meta分析：計算機檢索英文數據庫Pubmed、Cochrane圖書館、Embase、Medline，中文數據庫中國知網、萬方、維普全文期刊數據庫，確定頭孢曲松、蘭索拉唑、美羅培南的適應癥及對照藥品，全世界范圍內搜集關于此三種藥物與對照藥治療相應疾病的隨機對照試驗。采用RevMan5.0軟件進行數據分析。2.經濟學評價：依據Meta分析與專家咨詢對三個藥物建立決策樹模型，根據山東省物價局-醫(yī)藥價格網得到成本價格進行成本-效果分析，，最后對所得結果進行敏感性分析。 結果：1.頭孢曲松對照藥品：依諾沙星、環(huán)丙沙星、頭孢克肟。適應疾病：非復雜性淋病(Uncomplicated gonorrhoea)。Meta分析共納入8個隨機對照試驗，1441患者進行了治愈率比較，療效評定指標只針對治療5～8天后非復雜性淋病治愈率，沒有對其它指標進行分析，幾種藥物在治療非復雜性淋病中的遠期療效差異不明顯。經濟學評價中，通過成本-效果分析，結果環(huán)丙沙星組治療淋病CER、ICER均最低，表明環(huán)丙沙星組為治療非復雜性淋病期望值最高的藥物，敏感性分析表明結果穩(wěn)定。2.蘭索拉唑對照藥品：埃索美拉唑、奧美拉唑、泮托拉唑。適應疾�。何甘彻芊戳鞑�(gastroesophageal reflux disease,GERD)。Meta分析共納入11個隨機對照試驗，9345患者進行了治愈率比較，療效評定指標只針對治療4周、8周后胃食管反流病治愈率，沒有對其它指標進行分析，各種質子泵抑制劑（proton pump inhibitors,PPIs）在治療GERD中的遠期療效差異不明顯。經濟學評價中，通過成本-效果分析，結果奧美拉唑CER、ICER均為4藥中最低，故本研究中，奧美拉唑為治療胃食管反流病期望值最高的藥物，敏感性分析表明結果穩(wěn)定。3.美羅培南對照藥品：亞胺培南/西司他丁。適應疾病：腹腔感染(intra-abdominal infections)。Meta分析共納入5個隨機對照試驗，861患者進行了治愈率比較，療效評定指標只針對治療約5~10天后腹腔感染治愈率，沒有對其它指標進行分析，兩種藥物在治療腹腔感染中的遠期療效差異不明顯。經濟學評價中，通過成本-效果分析，亞胺培南/西司他丁CER、ICER均最低，故亞胺培南/西司他丁為治療腹腔感染期望值較高的藥物，敏感性分析表明結果穩(wěn)定。 結論：本課題對頭孢曲松、蘭索拉唑、美羅培南臨床療效進行了Meta分析，經濟學評價，方法科學合理、準確可行。
[Abstract]:Objective: to analyze the clinical efficacy of ceftriaxone, lansoprazole, meropenem, and the related documents of main databases at home and abroad, and to find out the clinical efficacy of ceftriaxone, lansoprazole and meropenem. In order to provide the basis for rational use of drugs in clinic, the economic aspects are summarized and summarized and comprehensive evaluation data are established. Methods 1. Meta-analysis: computer-based search of the English database Pubmedmedan Cochrane Library Embase Medline, Chinese database China Zhiwang, Wanfang, Weip full-text journal database, determination of ceftriaxone, lansoprazole, meropenem indications and control drugs. A randomized controlled trial of the three drugs and control drugs for the treatment of the disease was collected worldwide. Using RevMan5.0 software for data analysis. 2. Economic evaluation: according to Meta analysis and expert consultation, the decision tree model of three drugs was established, and the cost-effect analysis was carried out according to Shandong Price Bureau and Pharmaceutical Price Network. Finally, the sensitivity of the results was analyzed. The result is 1: 1. Ceftriaxone control drug: enoxacin, ciprofloxacin, cefixime. Adaptive disease: the cure rate of non-complicated gonorrhea patients was compared in 8 randomized controlled trials of 14 41 patients with non-complicated gonorrhea by gonorrhoea).Meta analysis. The evaluation index of curative effect was only for the cure rate of non-complicated gonorrhea after 5 ~ 8 days treatment, but no analysis was made on other indexes. The long-term effects of several drugs in the treatment of non-complicated gonorrhea are not significant. In the economic evaluation, the results of cost-effect analysis showed that ciprofloxacin group had the lowest CERICER for gonorrhea, indicating that ciprofloxacin group was the most expected drug for the treatment of non-complicated gonorrhea, and sensitivity analysis showed that the results were stable. Lansoprazole control drug: esomeprazole, omeprazole, Pam Tora. Adaptive disease: gastroesophageal reflux disease GERDN. Meta-analysis was conducted in 11 randomized controlled trials (n = 9 345) to compare the cure rate. The curative effect evaluation index was only for the cure rate of gastroesophageal reflux disease after 4 weeks and 8 weeks of treatment, but no analysis was made on other indexes. There was no significant difference between proton pump inhibitors and PPIsin in the treatment of GERD. In economic evaluation, cost-effect analysis showed that omeprazole CERICER was the lowest of the 4 drugs. Therefore, omeprazole was the most expected drug in the treatment of gastroesophageal reflux disease. The sensitivity analysis showed that the results were stable. 3. Meropenem: imipenem / cilastatin. Adaptive disease: Intraperitoneal infection intra-abdominal infections).Meta analysis was used to compare the cure rate of 5 randomized controlled trials in 861 patients. The curative effect evaluation index was only aimed at the cure rate of abdominal infection after 5 ~ 10 days of treatment, but no analysis was made on other indexes. There was no significant difference between the two drugs in the treatment of abdominal infection. In the economic evaluation, imipenem / cilastatin ICER was the lowest by cost-effect analysis, so imipenem / cilastatin was the most expected drug for the treatment of abdominal infection. The sensitivity analysis showed that the results were stable. Conclusion: the clinical effects of ceftriaxone, lansoprazole and meropenem were analyzed by Meta.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R969

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本文編號：1857546