CAJ | 학술논문

比较国家基本药物中口服降糖药治疗2型糖尿病的经济效果.选取体重指数19～27 kg/m2的2型糖尿病患者200例,分为5组,每组40例,分别给予格列本脲(A组)、格列吡嗪(B组)、二甲双胍(C组)、格列本脲+二甲双胍(D组)、格列吡嗪+二甲双胍(E)进行治疗,观察疗效,采用药物经济学中的成本-效果分析法(CEA)进行分析.5组均可有效控制血糖,均可显著降低HbA1c.格列本脲更符合药物经济学原则,但由于易发生严重而持久的低血糖限制其临床广泛应用,老年患者应更加慎重；在以控制空腹血糖和体重为主要目标时选择二甲双胍更经济；在以控制餐后血糖为主要目标时选择格列吡嗪更为合理,尤其是体形偏瘦者更为合适；格列吡嗪+二甲双胍联合用药方案适合单用格列吡嗪或二甲双胍效果不佳者,值得推荐.
비교국가기본약물중구복강당약치료2형당뇨병적경제효과.선취체중지수19～27 kg/m2적2형당뇨병환자200례,분위5조,매조40례,분별급여격렬본뇨(A조)、격렬필진(B조)、이갑쌍고(C조)、격렬본뇨+이갑쌍고(D조)、격렬필진+이갑쌍고(E)진행치료,관찰료효,채용약물경제학중적성본-효과분석법(CEA)진행분석.5조균가유효공제혈당,균가현저강저HbA1c.격렬본뇨경부합약물경제학원칙,단유우역발생엄중이지구적저혈당한제기림상엄범응용,노년환자응경가신중；재이공제공복혈당화체중위주요목표시선택이갑쌍고경경제；재이공제찬후혈당위주요목표시선택격렬필진경위합리,우기시체형편수자경위합괄；격렬필진+이갑쌍고연합용약방안괄합단용격렬필진혹이갑쌍고효과불가자,치득추천.
To compare the economic efficacies of the oral antidiabetic drugs in National Essential Medicine for treating type 2 diabetes mellitus.200 diabetic patients with body mass indices between 19-27 kg/m2 were assigned into 5 groups:group A received glibenclamide,group B glipizide,group C metformin,group D glibenclamide +metformin,and group E glipizide + metformin.Pharmacoeconomic evaluation was performed by cost-effectiveness analysis( CEA ).Fasting glucose level in patients treated with these 5 drugs all decreased significantly,as well as HbA1c.Glibenclamide was more in line with the principles of pharmacoeconomics,but should be used carefully for its serious and prolonged hypoglycemia,especially in elderly patients.According to the method of cost-effectiveness analysis,it was more economical to use metformin to control fasting glucose level while it is more reasonable to use glipizide to control the postprandial glucose whereas controlling of postprandial blood glucose is considered as a priority.Glipizide+mefformin combination may be recommended to the patients whose blood glucose level is poorly controlled by a single drug alone.