Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia
Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia
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幽门螺杆菌根除治疗非溃疡性消化不良的系统评价及经济评价
DOI：
10.1136/bmj.321.7262.659
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
B. Delaney
中科院分区：
文献类型：
--
作者：
P. Moayyedi;S. Soo;J. Deeks;D. Forman;J. Mason;M. Innes;B. Delaney
摘要目的：评价幽门螺杆菌根除治疗幽门螺杆菌感染的非溃疡性消化不良患者的疗效和成本效益。设计：系统回顾比较幽门螺杆菌根除与安慰剂或其他药物治疗的随机对照试验。结果被纳入马尔可夫模型，比较一年内根除幽门螺杆菌与抗酸治疗的卫生服务成本和收益。资料来源：检索了1966年1月至2000年5月的6个随机对照试验电子数据库。我们联系了该领域的专家、制药公司和期刊，以获取任何未发表试验的信息。根据预先确定的资格和质量标准对试验报告进行审查。主要结局指标：3-12个月时剩余消化不良症状（相同或更严重）的相对风险降低。根据马尔可夫模型估计的每个月无消化不良的成本，该模型基于估计的相对风险降低。结果：系统评价纳入了12项试验，其中9项评估了2541例患者3-12个月时的消化不良。在治疗非溃疡性消化不良方面，幽门螺杆菌根除治疗明显优于安慰剂（相对风险降低9%(95%置信区间为4%至14%)），每15名接受治疗的患者中有1例消化不良被治愈。在治疗后的第一年，根除幽门螺杆菌的费用为每个无消化不良月56英镑。结论：幽门螺杆菌根除可能是感染患者非溃疡性消化不良的成本有效的治疗方法，但需要进一步的证据来证明决策者是否愿意为缓解消化不良买单。
Abstract Objectives: To evaluate efficacy and cost effectiveness of Helicobacter pylori eradication treatment in patients with non-ulcer dyspepsia infected with H pylori. Design: Systematic review of randomised controlled trials comparing H pylori eradication with placebo or another drug treatment. Results were incorporated into a Markov model comparing health service costs and benefits of H pylori eradication with antacid treatment over one year. Data sources: Six electronic databases were searched for randomised controlled trials from January 1966 to May 2000. Experts in the field, pharmaceutical companies, and journals were contacted for information on any unpublished trials. Trial reports were reviewed according to predefined eligibility and quality criteria. Main outcome measures: Relative risk reduction for remaining dyspeptic symptoms (the same or worse) at 3-12 months. Cost per dyspepsia-free month estimated from Markov model based on estimated relative risk reduction. Results: Twelve trials were included in the systematic review, nine of which evaluated dyspepsia at 3-12 months in 2541 patients. H pylori eradication treatment was significantly superior to placebo in treating non-ulcer dyspepsia (relative risk reduction 9% (95% confidence interval 4% to 14%)), one case of dyspepsia being cured for every 15 people treated. H pylori eradication cost £56 per dyspepsia-free month during first year after treatment. Conclusion: H pylori eradication may be cost effective treatment for non-ulcer dyspepsia in infected patients but further evidence is needed on decision makers' willingness to pay for relief of dyspepsia.
用低剂量抗酸剂或西咪替丁治愈良性胃溃疡。
DOI：
10.1056/nejm198306023082203
发表时间：
1983
期刊：
The New England journal of medicine
影响因子：
--
作者：
Isenberg,JI;Peterson,WL;Elashoff,JD;Sandersfeld,MA;Reedy,TJ;Ippoliti,AF;VanDeventer,GM;Frankl,H;Longstreth,GF;Anderson,DS
通讯作者：
Anderson,DS