养心定悸胶囊治疗快速性心律失常的Meta分析和成本-效果

Meta Analysis and Cost-effectiveness of Yangxin Dingji Capsule in the Treatment of Tachyarrhythmia

目的比较养心定悸胶囊联合常规西医疗法和常规西医疗法治疗快速性心律失常的临床疗效和经济性。方法对养心定悸胶囊联合常规西医疗法和常规西医疗法治疗快速性心律失常进行Meta分析。建立决策树模型,从医疗系统角度进行成本-效果分析。效果参数为临床有效率来源于临床文献Meta分析,成本参数为药品治疗成本,计算增量成本-效果比(ICER),并通过单因素敏感性分析检验基础分析结果的稳定性。结果Meta分析结果显示,疗程为8周时,养心定悸胶囊联合常规西医疗法与常规西医疗法相比,治疗快速性心律失常的临床疗效更优,差异有统计学意义[OR=3.32,95%CI(2.22~4.96),P<0.00001];疗程为4周时,养心定悸胶囊联合常规西医疗法与常规西医疗法相比,治疗快速性心律失常的临床疗效更优,差异有统计学意义[OR=2.39,95%CI(1.45~3.96),P=0.0007]。成本-效果分析显示,疗程为8周时,养心定悸胶囊联合常规西医疗法较常规西医疗法治疗心律失常的临床有效率每增加1%,成本增加91.78元;疗程为4周时,养心定悸胶囊联合常规西医疗法较常规西医疗法治疗心律失常的临床有效率每增加1%,成本增加70.84元。结论治疗快速性心律失常,养心定悸胶囊联合常规西医疗法的临床疗效优于常规西医疗法,当意愿支付值大于相应的ICER值,养心定悸胶囊联合常规西医疗法比常规西医疗法更具有经济性。

Objective To compare the clinical efficacy and economy of Yangxin Dingji capsule combined with conventional western medicine therapy and conventional western medicine therapy in the treatment of tachyarrhythmia.Methods A Meta-analysis was made on the treatment of tachyarrhythmia by Yangxin Dingji capsule combined with conventional western medicine therapy and conventional western medicine therapy.A decision tree model is established to carry out cost-effectiveness analysis from the perspective of medical system.Efficacy parameter was clinical effective rate derived from clinical literature meta-analysis,cost parameter was drug treatment cost,incremental cost-effectiveness ratio(ICER)was calculated,and the stability of basic analysis results was tested by single factor sensitivity analysis.Results The results of Meta-analysis showed that when the course of treatment was 8 weeks,compared with conventional western medicine therapy,the clinical efficacy of Yangxin Dingji capsule combined with conventional western medicine therapy treating tachyarrhythmia was better,and the difference was statistically significant[OR=3.32,95%CI(2.22~4.96),P<0.00001];When the course of treatment was 4 weeks,the clinical efficacy of Yangxin Dingji capsule combined with conventional western medicine therapy treating tachyarrhythmia was better,and the difference was statistically significant[OR=2.39,95%CI(1.45~3.96),P=0.0007].The cost-effectiveness analysis showed that when the course of treatment was 8 weeks,the clinical effective rate of Yangxin Dingji capsule combined with conventional western medicine therapy in the treatment of arrhythmia increased by 1%,and the cost increased by 91.78 yuan;When the course of treatment was 4 weeks,the clinical effective rate of Yangxin Dingji capsule combined with conventional western medicine therapy in the treatment of arrhythmia increased by 1%and the cost increased by 70.84 yuan.One-way sensitivity analysis showed that the results were robust.Conclusion In the treatment of tachyarrhythmia,the clinical efficacy of Yangxin Dingji capsule combined with conventional western medicine therapy is superior to that of conventional western medicine therapy.When the willingness to pay value is greater than the corresponding ICER value,Yangxin Dingji capsule combined with conventional western medicine therapy is more economical than conventional western medicine therapy.