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目的评价瑞格列奈、门冬胰岛素30或预混重组人胰岛素30R治疗对二甲双胍单药失效的2型糖尿病患者的经济学效果。方法选择确诊为2型糖尿病患者并经盐酸二甲双胍单药治疗后糖化血红蛋白未达标者372例,按给药方案A组为瑞格列奈+盐酸二甲双胍,B组为精蛋白生物合成人胰岛素注射剂(预混30R)+盐酸二甲双胍,C组为门冬胰岛素30注射剂+盐酸二甲双胍治疗,治疗12周后观察疗效,并应用成本—效果法进行分析。结果 A、B、C组成本分别为(758.24±69.49)元,(715.75±140.11)元和(942.62±248.70)元,空腹血糖的下降率分别为50.70%、58.94%、69.97%,餐后2h血糖下降率分别为49.02%、46.73%和68.96%,糖化血红蛋白的下降率分别为63.51%、51.07%和57.91%。A、B、C组的成本效果比(C/E)在降低空腹血糖时分别为14.96、12.14和13.47,在降低餐后2h血糖时分别为15.47、15.32和13.67,在降低糖化血红蛋白时分别为11.94、14.02和16.28。结论就经济学效果而言,降低空腹血糖以B方案优于A、C方案,降低餐后2h血糖则是C方案优于A、B方案,而降低糖化血红蛋白方面A方案优于B、C方案。
Objectives To evaluate the economic efficacy of repaglinide, insulin aspart 30, or premixed recombinant human insulin 30R in patients with type 2 diabetes who have met the metformin monotherapy failure. Methods 372 patients with type 2 diabetes mellitus who did not meet the criteria of glycosylated hemoglobin after treatment with metformin hydrochloride alone were treated with repaglinide + metformin according to the schedule of administration and group B with protamine biosynthesis human insulin injection Premixed 30R) + metformin hydrochloride. Group C was treated with insulin aspart 30 injection and metformin hydrochloride. After 12 weeks of treatment, the curative effect was observed and the cost-effect method was used for the analysis. Results The costs of A, B and C groups were (758.24 ± 69.49) yuan, (715.75 ± 140.11) yuan and (942.62 ± 248.70) yuan respectively. The decreasing rates of fasting blood glucose were 50.70%, 58.94% and 69.97% The rate of decrease of blood glucose was 49.02%, 46.73% and 68.96%, and the decrease rate of HbAc were 63.51%, 51.07% and 57.91% respectively. The cost-effectiveness ratio (C / E) of group A, B and C were 14.96, 12.14 and 13.47 when they decreased fasting blood glucose, 15.47, 15.32 and 13.67 respectively when their blood glucose decreased 2h after meal, 11.94, 14.02 and 16.28. Conclusions In terms of economic effect, reducing fasting blood glucose is superior to programs A and C on B and lowering C 2 hours postprandial is superior to programs A and B, while HbA1c is superior to B and C on reducing HbAlc .