4种口服保肝药治疗药物性肝损伤的有效性、安全性和经济性分析

Evaluation of effectiveness,safety and economy of four oral hepatoprotectants in treatment of drug-induced liver injury

目的:对治疗药物性肝损伤的4种口服保肝药物进行有效、安全、经济性分析,为临床合理用药提供参考。方法:对2009年5月至2016年5月某医院263例药物性肝损伤患者用药进行回顾性分析,从药物疗效、不良反应及成本3个方面对4种口服保肝药物进行评价,并采用药物经济学分析方法,对4种口服保肝药的经济性进行比较。结果:药物疗效评价结果显示4种药物治疗药物性肝损伤临床疗效无统计学差异(P>0.05);安全性评价结果显示4组患者不良反应发生率无显著差异(P>0.05);药物成本比较结果显示甘草酸二铵成本最低,还原型谷胱甘肽成本最高;最小成本分析结果显示,甘草酸二铵的经济性较好。结论:4种口服保肝药治疗该医院263例药物性肝损伤患者的研究结果表明,不能证明其在临床疗效和不良反应发生率上有差异;在成本分析上,甘草酸二胺成本最低,还原型谷胱甘肽成本最高,最小成本分析结果显示甘草酸二胺的经济性较好。

Objective： To perform a comprehensive evaluation of effectiveness,safety and economy of four oral hepatoprotectants to provide reference for clinical treatment. Methods： The clinical efficacy,adverse reactions and direct medical costs of four oral hepatoprotectants for treatment of 263 patients with drug-induced liver injury（ DILI） from May 2009 to May 2016 were retrospective analyzed. The economy of the four drugs was compared with pharmacoeconomic method. Results： The four oral hepatoprotectants showed no significant difference in therapeutic efficacy for efficacy（ P 〉 0. 05）. Safety evaluation showed that the there was no significant difference in the incidence of adverse reactions for the four drugs（ P 〉 0. 05）. Drug cost comparison showed that diammonium glycyrrhizinate had the lowest cost,while reduced glutathione had the highest one. Cost-minimization analysis showed that diammonium glycyrrhizinate had better economical efficiency. Conclusion： There were no significant differences in the efficacy and adverse reactions among the four kinds of oral hepatoprotective drugs for treatment of drug-induced liver injury in 263 patients. According to the cost analysis,diammonium glycyrrhizinate has the lowest cost,while reduced glutathione has the highest one. Cost-minimization analysis showed that diammonium glycyrrhizinate has the best economical efficiency.