Summary： Evidence-based medicine is advocated by WHO and adopted by developed countries for many years. In China, however, the selection of essential medicine and various medical insurance reimbursement schemes medic...Summary： Evidence-based medicine is advocated by WHO and adopted by developed countries for many years. In China, however, the selection of essential medicine and various medical insurance reimbursement schemes medicine is usually based on experts＇ experience of prescription practice which is under heavy critics resulting from the lack of related comparative efficacy and evidence-based research. The efficacy of Jian＇ganle in prevention of drug-induced liver injury （DILI） caused by antituberculotics was evaluated in this study by comparison with Hugan Pian, glucuronolactone and reduced glutathione. Evidence was provided for relevant sectors such as Ministry for Human Resources and Social Security of the People＇s Republic of China and National Health and Family Planning Commission of the Peo- ple＇s Republic of China to select and renew the Essential Medicine List （EML）, the new rural cooperative medical scheme in China （NRCMS） list or the reimbursement list of industrial injury insurance. A total of 189 patients with initial pulmonary tuberculosis were divided into four groups who took antituberculotics combined with Jian＇ganle, Hugan Pian, glucuronolactone and reduced glutathione respectively. Their liver function profile including alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL）, direct bilirubin （DBIL）, total protein （TP）, albumin （A） and globulin （G） were detected at admission as baseline and after treatment. The Jian＇ganle group was compared with the three others by chi-square tests. In an aspect of maintaining bilirubin indexes normal, Jian＇ganle was more efficacious than glucuronolactone. And Jian＇ganle had a little more efficacy than reduced glutathione to maintain protein indexes normal as well. And the therapeutic regimen of antituberculotics combined with Jian＇ganle was the best in treating tuberculosis and preventing DILI at the same time. The study showed that among the four hepatinicas which demonstrate展开更多
目的:对富马酸伏诺拉生片与艾普拉唑肠溶片进行卫生技术评估,为医疗机构遴选药品提供证据。方法:使用课题组基于证据与价值对决策的影响(evidence and value impact on decision making,EVIDEM)建立的医疗机构药品遴选多准则循证决策框...目的:对富马酸伏诺拉生片与艾普拉唑肠溶片进行卫生技术评估,为医疗机构遴选药品提供证据。方法:使用课题组基于证据与价值对决策的影响(evidence and value impact on decision making,EVIDEM)建立的医疗机构药品遴选多准则循证决策框架(包括5个评估领域、13个评估准则)对两药进行评估,药品价值估算通过线性加权进行计算。结果:伏诺拉生与艾普拉唑在各评估领域价值估算分别为:临床需求0.36 vs.0.36、临床价值0.54 vs.0.51、患者价值0.46 vs.0.09、经济价值0.08 vs.0、社会影响0.48 vs.0.42,药品价值估算1.93 vs.1.37。结论:基于EVIDEM决策框架,伏诺拉生的评估结果优于艾普拉唑。EVIDEM决策框架可以将循证证据转化为药品价值估算,用于遴选药品的排序和比较,辅助决策者做出科学决策。展开更多
基金supported by Health and Family Planning Commission of Hubei Province(No.02-16-516052)
文摘Summary： Evidence-based medicine is advocated by WHO and adopted by developed countries for many years. In China, however, the selection of essential medicine and various medical insurance reimbursement schemes medicine is usually based on experts＇ experience of prescription practice which is under heavy critics resulting from the lack of related comparative efficacy and evidence-based research. The efficacy of Jian＇ganle in prevention of drug-induced liver injury （DILI） caused by antituberculotics was evaluated in this study by comparison with Hugan Pian, glucuronolactone and reduced glutathione. Evidence was provided for relevant sectors such as Ministry for Human Resources and Social Security of the People＇s Republic of China and National Health and Family Planning Commission of the Peo- ple＇s Republic of China to select and renew the Essential Medicine List （EML）, the new rural cooperative medical scheme in China （NRCMS） list or the reimbursement list of industrial injury insurance. A total of 189 patients with initial pulmonary tuberculosis were divided into four groups who took antituberculotics combined with Jian＇ganle, Hugan Pian, glucuronolactone and reduced glutathione respectively. Their liver function profile including alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL）, direct bilirubin （DBIL）, total protein （TP）, albumin （A） and globulin （G） were detected at admission as baseline and after treatment. The Jian＇ganle group was compared with the three others by chi-square tests. In an aspect of maintaining bilirubin indexes normal, Jian＇ganle was more efficacious than glucuronolactone. And Jian＇ganle had a little more efficacy than reduced glutathione to maintain protein indexes normal as well. And the therapeutic regimen of antituberculotics combined with Jian＇ganle was the best in treating tuberculosis and preventing DILI at the same time. The study showed that among the four hepatinicas which demonstrate
文摘目的:对富马酸伏诺拉生片与艾普拉唑肠溶片进行卫生技术评估,为医疗机构遴选药品提供证据。方法:使用课题组基于证据与价值对决策的影响(evidence and value impact on decision making,EVIDEM)建立的医疗机构药品遴选多准则循证决策框架(包括5个评估领域、13个评估准则)对两药进行评估,药品价值估算通过线性加权进行计算。结果:伏诺拉生与艾普拉唑在各评估领域价值估算分别为:临床需求0.36 vs.0.36、临床价值0.54 vs.0.51、患者价值0.46 vs.0.09、经济价值0.08 vs.0、社会影响0.48 vs.0.42,药品价值估算1.93 vs.1.37。结论:基于EVIDEM决策框架,伏诺拉生的评估结果优于艾普拉唑。EVIDEM决策框架可以将循证证据转化为药品价值估算,用于遴选药品的排序和比较,辅助决策者做出科学决策。
