基于Meta分析的稳心颗粒治疗心血管疾病的药物经济学评价
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篇名: 基于Meta分析的稳心颗粒治疗心血管疾病的药物经济学评价
TITLE:
摘要: 目的:基于Meta分析评价稳心颗粒治疗心血管疾病的有效性、安全性和经济性。方法:以“稳心颗粒”“稳心”“Wenxinkeli”“Wenxin”等为检索词,计算机检索PubMed、ProQuest、Springer、The Cochrane Library、中国知网、维普及万方等数据库(2000年1月-2015年10月),并手工检索相关期刊与会议论文,筛选稳心颗粒治疗心血管疾病的随机对照试验文献,根据适应证进行归类整理;利用RevMan 5.3软件进行Meta分析,采用成本-效果分析和最小成本分析法进行经济学评价。结果:共纳入38篇文献,其中稳心颗粒治疗心律失常20篇、室性早搏9篇、冠心病心绞痛4篇、不稳定型心绞痛3篇、小儿病毒性心肌炎2篇。Meta分析结果显示,稳心颗粒与对照药比较,治疗心律失常的临床疗效更优、不良反应发生率更低;治疗室性早搏的临床疗效和心电图疗效更优、不良反应发生率更低;治疗冠心病心绞痛、稳定型心绞痛和小儿病毒性心肌炎的临床疗效更优,差异均有统计学意义(P<0.05)。增量成本-效果分析结果显示,稳心颗粒治疗以上适应证较对照药增加的成本完全值得。单因素敏感度分析证实了结果的稳定性。结论:稳心颗粒治疗心血管疾病有较好的有效性、安全性和经济性,但尚需高质量的文献证据支撑。
ABSTRACT: OBJECTIVE: To evaluate the effectiveness, safety and economy about Wenxin granules in the treatment of cardiovascular diseases based on Meta-analysis. METHODS: Using “Wenxin granules” “Wenxinkeli” “Wenxin” as the search terms, searching PubMed, ProQuest, Springer, The Cochrane Library, CNKI, VIP and Wanfang data (Jan. 2000-Oct. 2015) through computer, relevant journals and conference papers by hand, randomized controlled trials about Wenxin granules in the treatment of cardiovascular diseases were screened and classified according to indications. Meta-analysis was performed by using RevMan 5.3 software, while cost-effectiveness analysis and minimum cost analysis were used for economic evaluation. RESULTS: Totally, 38 literatures were involved, including 20 literatures of arhythmia, 9 of premature ventricualr contraction, 4 of coronary disease angina pectoris, 3 of unstable angina pectoris, 2 of pediatric viral myocarditis. Meta-analysis showed that compared with control drug, Wenxin granules showed better clinical efficacy for arrhythmia with less ADR; showed better clinical efficacy and ECG efficacy for premature ventricualr contraction with less ADR; showed better clinical efficacy for angina pectoris of coronary disease, unstable angina pectoris and pediatric viral myocarditis, with statistical significance (P<0.05). The incremental cost-effectiveness analysis showed that the additional cost of Wenxin granules in the treatment of above indications was worth it all, compared to control drug. Single factor sensitivity analysis supported the stability of results. CONCLUSIONS: Wenxin granules have a better effectiveness, safety and economy in the treatment of cardiovascular diseases, but still need high-quality evidence to support.
期刊: 2017年第28卷第5期
作者: 王小艺,卢颖,冯晓远,王英,王煊,朱文涛
AUTHORS: WANG Xiaoyi,LU Ying,FENG Xiaoyuan,WANG Ying,WANG Xuan,ZHU Wentao
关键字: 稳心颗粒;心血管疾病;系统评价;药物经济学
KEYWORDS: Wenxin granules; Cardiovascular disease; Systematic review; Pharmacoeconomic
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