摘要
目的基于文献数据，评价脑心通胶囊治疗心绞痛、脑梗死和血管性痴呆成本-效果。方法检索2000年1月1日~2015年9月7日国内外中英文数据库，收集脑心通胶囊治疗冠心病心绞痛、脑梗死和血管性痴呆的随机对照试验文献，采用Revman5.0软件对符合纳排标准的研究进行统计分析，对各病症的主要结局指标进行药物经济学评价。结果共纳人研究39个，其中冠心病10篇，脑梗塞14篇，血管性痴呆15篇。Meta分析结果显示：①在脑心通胶囊治疗心绞痛疗效中与对照组，中药对照组及复方丹参片比较具有统计学意义（P<0.05);在心电图疗效中与对照药比较无统计学意义（P=0.11)，与中药治疗组（P=0.002)和复方丹参片（P=0.05)比较具有统计学意义；在安全性分析中与对照药比较无统计学意义（P=0.79)。②在脑心通胶囊治疗脑梗塞的临床疗效中无统计学意义（P=0.09)，与中药治疗组比较具有统计学意义（P=0.03)。③在脑心通胶囊治疗血管性痴呆的临床疗效、MMSE量表评分、在ADL量表评分、血浆粘度等血液流变学指标中与对照药比较具有统计学意义（P<0.05)。药物经济学分析结果显示：脑心通胶囊在治疗冠心病心绞痛、脑梗死中，其经济性均优于通心络胶囊，次于复方丹参片和地奥心血康胶囊。通过与复方丹参片的增量成本-效果分析发现，在心绞痛疗效方面，脑心通胶囊每增加1个疗效，多花费6.4元，在心电图疗效方面，脑心通胶囊每增加1个疗效，多花8.01元；脑心通胶囊在治疗血管性痴呆病症中，其经济性优于都可喜片。结论脑心通胶囊在冠心病心绞痛、脑梗死、血管性痴呆的治疗中具有良好的临床效果和经济性。
Objective To evaluate the cost-effectiveness of Naoxintong Capsule in angina,cerebral infarction,and vascular dem entia.Methods Random ized controlled trials(RCTs)published in Chinese or English from2000.1.1to2015.9.7of angina,cerebral infarction,and vascular dem entia were collected from literature databases.Statistical analysis was conducted by RevMan5.0.Pharmacoeconomic evaluation was completed for main outcomeindicators.Result39RCTs were enrolled in the study,in which10for angina,14for cerebral infarction and15forvascular dementia.The results of m eta-analysis showed th a t:①with respect to angina,the efficacy between controlgroup,Chinese medicine group and Danshen group with Naoxintong group was statistically significant(P<0.05);withrespect to efficacy on electrocardiogram(ECG),no difference was observed between control group and Naoxintonggroup(P=0.11);statistical difference was observed between Chinese medicine group(P=0.002)and Danshen group(P=0.05)with Naoxintong group;no difference was observed between control group and Naoxintong group in safetyanalysis(P=0.79).②with respect to cerebral infarction,no difference was observed(P=0.09)in clinical efficacy,expect compared with Chinese medicine group(P=0.03).③with respect to vascular dementia,statistical differencewas observed between control group and Naoxintong group in clinical curative effect,MMSE scale score,ADLscale score(P<0.05).The results of pharmacoeconomic analysis showed that:with respect to economic efficiency oftreatment of angina and cerebral infarction,Naoxintong capsule is better than Tongxinluo,but inferior to Danshenand DiAo Xinxuekang Capsule.Using Naoxintong capsule,each additional one effect of angina will cost6.4yuan;each additional one effect of ECG will cost8.01yuan;with respect to economic efficiency of treatment of vasculardem entia,Naoxintong capsule is better than Duxil.Conclusion On treatm ent of angina,cerebral infarction,vascular dementia,Naoxintong Capsule has good clinical effect and cost-effectiveness.
作者
王英
张昱
王小艺
冯晓远
王煊
朱文涛
WANG Ying;ZHANG Yu;WANG Xiao-yi;FENG Xiao-yuan;WANG Xuan;ZHU Wen-tao(School o f Management, Beijing University of Chinese Medicine, Beijing, 100029, China)
出处
《中国循证心血管医学杂志》
2016年第11期1379-1385,共7页
Chinese Journal of Evidence-Based Cardiovascular Medicine
