基于Meta分析的盐酸川芎嗪注射液治疗冠心病心绞痛的药物经济学评价

Pharmacoeconomic Evaluation of Ligustrazine Hydrochloride Injection in the Treatment of Cardiovascular Diseases Based on Meta-analysis

目的:基于Meta分析方法评价盐酸川芎嗪注射液治疗冠心病心绞痛的有效性、安全性和经济性。方法:以"冠心病"、"心绞痛"、"盐酸川芎嗪注射液"等为关键词,计算机检索Pub Med、Embase、Cochrane图书馆、CNKI、VIP、中国期刊全文数据库、万方数据库、中国生物医学文献数据库,并手工检索相关期刊与会议论文,收集盐酸川芎嗪注射液治疗冠心病心绞痛的随机对照试验(RCTs);利用Rev Man 5.3软件对盐酸川芎嗪注射液治疗冠心病心绞痛的有效性和安全性进行Meta分析,采用增量成本效果分析法进行经济学评价。结果:共纳入12个RCTs,累计受试者972例。Meta分析结果显示,与单用西医常规疗法相比,盐酸川芎嗪注射液联合西医常规疗法治疗冠心病心绞痛能明显提高心绞痛总有效率(OR=3.09,95%CI:2.15~4.44,P<0.000 01)及心电图总有效率(OR=2.87,95%CI:1.89~4.37,P<0.000 01);能显著降低心绞痛的发作持续时间、发作次数和硝酸甘油用量,较好改善治疗后血液流变学指标,且不良反应发生率低,药物经济性也较好。结论:盐酸川芎嗪注射液在冠心病心绞痛治疗中具有良好的临床疗效及经济性,但尚需高质量的文献证据支撑。

Objective： To evaluate the effectiveness,safety and economy about ligustrazine hydrochloride injection in the treatment of cardiovascular diseases based on Meta-analysis. Methods： Using ＂coronary heart disease＂,＂angina pectoris＂,＂ligustrazine hydrochloride injection ＂as the search terms,searching Pub Med,Embase,Cochrane library,CNKI,VIP Data,CJFD,Wanfang datababase,and Sino Med through computer,relevant journals and conference papers by manual retrieval,randomized controlled trials（ RCTs） about ligustrazine hydrochloride injection in the treatment of cardiovascular diseases were screened and classified according to indications. Meta-analysis was performed by using Rev Man 5. 3 software,while cost-effectiveness analysis and minimum cost analysis were used for economic evaluation. Results： A total of12 RCTs and 972 subjects were included. The results showed that clinical effect and electrocardiogram efficacy in ligustrazine hydrochloride injection group were significantly better than those in control group（ OR = 3. 09,95% CI： 2. 15-4. 44 and OR = 2. 87,95% CI： 1. 89-4. 37,P〈0. 000 01）. And it could significantly reduce the duration of the angina pectoris,the frequency of attack and the dosage of nitroglycerin,and improve the blood rheology index after treatment of ligustrazine hydrochloride injection; showed a better effectiveness and economy with less ADR. Conclusion： Ligustrazine hydrochloride injection had a better effectiveness,safety and economy in the treatment of cardiovascular diseases,but still needed high-quality evidence to support.