4种口服保肝药治疗药物性肝损害的疗效与经济学分析

Therapeutic Efficacy and Economic Analysis of 4 Kinds of Oral Hepatoprotective Drugs in the Treatment of Drug-induced Liver Injury

目的:对4种口服保肝药治疗药物性肝损害的临床疗效与经济学进行分析,为临床合理用药提供参考。方法:回顾性研究2011-2012年在某医院门诊就诊的药物性肝损害患者211例,按口服保肝药的类别分为4组,分别为A组(甘草酸二铵胶囊150 mg,po,tid)、B组(水飞蓟宾胶囊140 mg,po,tid)、C组(硫普罗宁肠溶片200 mg,po,tid)、D组(还原型谷胱甘肽片400 mg,po,tid),疗程均为4周。观察各组的临床治疗效果和不良反应,并以最小成本法分析4种治疗方案的经济性。结果:A、B、C、D组总有效率分别为89.06%、91.49%、87.27%、91.11%,两两比较差异均无统计学意义(P>0.05);治疗成本分别为517.92、916.92、606.12、1 131.96元。A组的治疗成本最低,D组的最高,但C组与A组比较差异无统计学意义(P>0.05);A组与B组、D组比较差异均有统计学意义(P<0.05)。结论:4种药物中,甘草酸二铵胶囊和硫普罗宁肠溶片较水飞蓟宾胶囊、还原型谷胱甘肽片治疗成本更低。

OBJECTIVE： To analyze clinical efficacy and economics of 4 kinds of oral hepatoprotective drugs in the treatment of drug-induced liver injury, and to provide reference for rational drug use in the clinic. METHODS ： By retrospective study, 211 cases of drug-induced liver disease from 2011 to 2012 in outpatient department of a hospital were divided into 4 groups according to oral hepato- protective drug categories, i.e. group A （Diammonium glycyrrhizinate capsule 150 rag, p.o., rid）, group B （Silibinin capsules 140 mg, p.o., tid）, group C （Tiopronin enteric-coated tablets 200 mg, p.o., tid） and group D （Reduced glutathione tablets 400 mg, p.o., tid）. The treatment course lasted for 4 weeks. Minimum cost method was used to analyze the economics of 4 kinds of regimens. RE- SULTS ： The total effective rates of 4 groups were 89.06 %, 91.49 %, 87.27 % and 91.11%, respectively; there was no statistical signif- icance （P^0.05）. Treatment costs of them were 517.92 yuan, 916.92 yuan, 606.12 yuan and 1 131.96 yuan. Treatment cost of group A was the lowest while that of group D was the highest; there was no statistical significance between group A and group D （P〉0.05） ; there were statistical significance between group A and group B or group D （P〈 0.05）. CONCLUSIONS： Among 4 kinds of drugs, the treatment costs of Diammonium glycyrrhizinate capsules and Tiopronin enteric-coated tablets are lower than those of Silibinin capsules and Reduced glutathione tablets.