氯雷他定联合多塞平治疗慢性荨麻疹的成本－效果分析

目的探讨氯雷他定联合多塞平治疗慢性荨麻疹的疗效和经济学效果。方法采用前瞻性研究方 法，选取２０１２年３月-２０１３年３月经我院门诊诊治的慢性荨麻疹患者９０例，按数字随机法随机分为３组，每组各３０ 例，氯雷他定组给予氯雷他定治疗，多塞平组给予多塞平治疗，联合组给予氯雷他定联合多塞平治疗，比较３组临床 疗效、复发率、不良反应及成本－效果比。结果治疗４周后，联合组临床有效率为９０．００％，高于氯雷他定组和多 塞平组的７３．３３％和６６．６７％，差异有统计学意义（P＜０．０５）；但３组不良反应发生率比较差异无统计学意义（P＞ ０．０５）。治疗结束后１周内，氯雷他定组、多塞平组和联合组的复发率分别为３０．００％、２６．６７％和１３．３３％，氯雷他定 组和联合组比较，差异有统计学意义（P＜０．０５）。以多塞平组为参照，氯雷他定组和联合组的增量成本－效果比分别 为４６．９８和６．７１。结论氯雷他定联合多塞平治疗慢性荨麻疹的疗效更好，复发率更低，是较佳的治疗方案。

Cost-effectiveness of loratadine and doxepin in treatment of chronic urticaria

Objective To discuss the therapeutic efficacy and pharmacoeconomic outcome of loratadine and doxepin in the treatment of chronic urticaria. Methods A total of 90 patients with chronic urticaria from March2012 to March 2013 were randomly divided into 3groups,30 cases respectively.A loratadine group was given loratadine treatment,a doxepin group was given doxepin treatment,and a combined group was given loratadine combined with doxepin treatment,and then the curative effects,the recurrence rates,adverse reactions and cost-effectiveness ratios were investigated. Results Four weeks after the treatment,the clinical effective rate of the combined group（90.00%）was significantly higher than that of the loratadine group（73.33%）and that of the doxepin group（66.67%,P〈0.017）,but there was no significant difference in the incidence of adverse reactions among 3groups（P〉0.05）.Within 1week after the treatment,the recurrence rate of the loratadine group,doxepin group and combined group were 30.00%,26.67%and 13.33%respectively,and there was a significant difference between the loratadine group and combined group（P〈0.017）.Compared with the doxepin group,the incremental cost-effectiveness ratios of the loratadine group and combined group were 46.98 and 6.71. Conclusions Loratadine combined with doxepin have better curative effect and lower recurrence rate,and is a preferable therapy for chronic urticaria.