国产与进口硝苯地平控释片治疗高血压病的循证经济学评价

Pharmacoeconomic evaluation based on meta-analysis of domestic and imported nifedipine controlled release tablets for hypertension

目的系统评价国产与进口硝苯地平控释片对高血压病的治疗效果和经济效果。方法检索中国期刊全文数据库、万方医学数据库及中文科技期刊全文数据库,纳入国产与进口硝苯地平控释片对高血压病进行治疗的随机对照试验(RCT)文献,手工检索其他相关文献。并对纳入的研究进行质量评价,采用RevMan5.1软件进行Meta分析,最小成本分析法进行经济学评价。结果共有7篇随机对照试验文献的研究符合纳入标准。Meta分析结果显示:国产和进口硝苯地平控释片在总有效率、SBP和DBP下降幅度、不良反应发生率方面差异均无统计学意义(P>0.05)(RR=0.97、95%CI为0.92～1.02;MD=-1.63、95%CI为-6.49～3.24;MD=-0.59、95%CI为-2.97～1.79;RR=1.31、95%CI为0.88～1.95),2组成本比较有统计学意义(P<0.05)。结论目前证据表明国产和进口硝苯地平控释片治疗高血压病的疗效相近,国产硝苯地平控释片具有经济学优势,但二者平稳降压作用尚需进一步研究。

Objective To system atically evaluate domestic and imported nifedipine controlled release tablets in hypertension treatment effect and economic effect.Methods We searched Chinese journal full-text database,Wanfang medical database and Chinese science and technology periodical full-text database,incorporation of domestic and imported nifedipine controlled release tablets on hypertension therapy in a randomized controlled trial（RCT）literature,and other related literature.And research quality evaluation was done using RevMan5.1 software for meta analysis.Minimum cost analysis method was used for economic evaluation.Results A total of 7 randomized controlled trials of study met the inclusion criteria.Meta analysis results showed there were no statistically significant differences in the total efficiency,SBP and DBP decreased,the incidence of adverse reactions（P0.05）（RR=0.97,95%,CI 0.92~1.02;MD=-1.63,95%,CI-6.49~3.24;MD =-0.59,95%CI-2.97~1.79;RR=1.31,95%CI0.88~1.95）.There was statistic significance in costs between 2 groups（P0.05）.Conclusion The current evidence showed domestic and imported nifedipine controlled release tablets had similar efficacy in the treatment of hypertension.Domestic nifedipine has economic advantage,but stable hypotensive effect of the two still need further research.