基于Meta分析的血栓通联合天麻素注射液治疗脑血管疾病的药物经济学研究

Pharmacoeconomic Evaluation of combination of Xueshuantong and Tianma injection in the Treatment of Cerebrovascular Diseases Based on Meta-analysis

目的基于循证医学分析研究血栓通联合天麻素注射治疗脑血管疾病疗效与药物经济性,为二者临床联合用药提供指导依据。方法计算机检索PubMed、Embase、Cochrane图书馆、CNKI、VIP等数据库,收集血栓通联合天麻素注射液治疗脑血管疾病临床研究的随机对照试验(RCT),利用RevMan 5.3软件对其二者联用治疗临床疾病的有效性和安全性进行Meta分析,并采用增量成本效果分析法进行经济学评价。结果共纳入有效文献26篇,其中急性脑梗塞10篇、治疗后循环缺血眩晕9篇、基底动脉供血不足7篇。Meta分析结果显示血栓通联合天麻素注射液相对于单药治疗,在治疗急性脑梗塞、治疗后循环缺血眩晕、基底动脉供血不足等方面疗效更优,差异具有显著统计学意义(P<0.05);增量成本-效果分析结果显示,两药联合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。结论血栓通联合天麻素注射液在临床运用中具有较好的有效性、安全性和经济性,但尚需高质量的文献证据支撑。

Objective To evaluate the effectiveness,safety and economy about combination of Xueshuantong and Tianma injection in the Treatment of Cerebrovascular Diseases Based on Meta-analysis.Methods Using"Tianma injection"、"Xueshuantong injection"as the search terms,searching PubMed,Embase,Cochrane library,CNKI and VIP Data through computer,relevant journals and conference papers by hand,randomized controlled trials about combination of Xueshuantong and Tianma injection in the Treatment of Cerebrovascular 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 Totally,26 literatures were involved,including 10 literatures of cerebral infarction,9 of premature Circulatory ischemic vertigo after treatment(PCIV),7 of vertebrobasilar ischemia.Meta-analysis showed that compared with control drug,combination of Xueshuantong and Tianma injection showed better clinical efficacy for Cerebrovascular Diseases with less ADR;showed better clinical efficacy(P<0.05).The incremental cost-effectiveness analysis showed that the additional cost of combination of Xueshuantong and Tianma injection in the treatment of above indications was worth it all,compared to control drug.Single factor sensitivity analysis supported the stability of results.Conclusion Combination of Xueshuantong and Tianma injection have a better effectiveness,safety and economy in the treatment of Cerebrovascular diseases,but still need high-quality evidence to support.