摘要
目的:评估丹参酮ⅡA磺酸钠注射液联合常规用药对比常规用药治疗冠心病心绞痛的临床疗效和经济性。方法:以“丹参酮ⅡA磺酸钠”“丹参酮”“心绞痛”“Sodium tanshinoneⅡA sulfonate”“STS”“Danshentong”“Angina pectoris”等为中英文关键词,组合检索万方数据、中国知网、中国生物医学文献数据库、Cochrane图书馆、Medline、Embase、ISI Web of Science、BIOSIS Previews等数据库,检索时限均为建库起至2019年4月。筛选文献、提取资料后按照Cochrane系统评价员手册5.2.0偏倚风险工具对纳入的真实世界队列研究进行质量评价,采用Stata 15.0软件进行Meta分析,并对结果进行发表偏倚分析;采用成本-效果分析进行药物经济学评价,并对结果进行单因素敏感性分析和概率敏感性分析。结果:共纳入29篇文献,共计31项研究、2857例患者。Meta分析结果显示,试验组患者的临床有效率[RR=1.23,95%CI(1.18,1.28),P<0.001]、心电图有效率[RR=1.29,95%CI(1.20,1.39),P<0.001]、心绞痛有效率[RR=1.22,95%CI(1.15,1.29),P<0.001]均显著高于对照组;两组患者的不良反应均较轻微;上述结果存在发表偏倚的可能性大。成本-效果分析显示,两种方案的增量成本-效果比为72.02;敏感性分析显示上述结果稳健。结论:对于冠心病心绞痛患者,丹参酮ⅡA磺酸钠注射液联合常规用药方案对比常规用药方案的疗效更优,成本也略高;当支付意愿高于7202元时,联合方案更具有成本-效果优势。
OBJECTIVE:To evaluate the clinical efficacy and economics of Sodium tanshinoneⅡA sulfonate injection combined with conventional medication versus conventional medication in the treatment of angina pectoris of coronary heart disease.METHODS:Using“Sodium tanshinoneⅡA sulfonate”“Danshentong”“angina pectoris”as Chinese keywords and“Sodium tanshinoneⅡA sulfonate”“Danshentong”“Angina pectoris”as English keywords,the studies were retrieved from Wanfang database,CNKI,CBM,Cochrane Library,Medline,Embase,ISI Web of Science and BIOSIS Previews during the inception to Apr.2019.After literature screening and data extraction,the included real world cohort studies were evaluated with bias risk tool of Cochrane systematic evaluator manual 5.2.0.Meta-analysis was conducted by using Stata 15.0 software,and publication bias of results was analyzed.The cost-effectiveness analysis was used for pharmacoeconomic evaluate,and single factor sensitivity analysis and probability sensitivity analysis were carried out for the results of pharmacoeconomic evaluation.RESULTS:A total of 29 literatures were included,involving 31 studies and 2857 patients.Meta-analysis showed that clinical effective rate[RR=1.23,95%CI(1.18,1.28),P<0.001],ECG effective rate[RR=1.29,95%CI(1.20,1.39),P<0.001]and angina pectoris effective rate[RR=1.22,95%CI(1.15,1.29),P<0.001]of trial group were significantly higher than those of control group.The adverse reactions of the two groups were mild.The above results were likely to be biased in publication.Cost-effectiveness analysis showed that ICER was 72.02 of 2 groups.The sensitivity analysis showed that above results were stable.CONCLUSIONS:For patients with angina pectoris of coronary heart disease,therapeutic efficacy of Sodium tanshinoneⅡA sulfonate injection combined with conventional medication is better that of conventional medication,and the cost is also slightly higher.When the willingness to pay is higher than 7202 yuan,the combination scheme has the advantage of cost-effectiveness.
作者
刘洁
万楚川
陈磊
席晓宇
LIU Jie;WAN Chuchuan;CHEN Lei;XI Xiaoyu(National Drug Policy and Pharmaceutical Industry Economic Research Center,China Pharmaceutical University,Nanjing 211198,China)
出处
《中国药房》
CAS
北大核心
2020年第18期2240-2246,共7页
China Pharmacy
基金
江苏省教育厅高校哲学社会科学研究一般项目(No.2019SJA0062)
中国药科大学“双一流”学科创新团队建设项目(No.CPU2018GY39)。
关键词
丹参酮ⅡA磺酸钠
冠心病心绞痛
META分析
疗效
成本-效果分析
Sodium tanshinoneⅡA sulfonate
Angina pectoris of coronary heart disease
Meta-analysis
Therapeutic efficacy
Cost-effectiveness analysis
作者简介
刘洁,硕士研究生。研究方向:卫生经济学与药学服务。E-mail:ljbelle@163.com;通信作者:席晓宇,讲师,博士。研究方向:卫生经济学与药学服务。E-mail:cpuxixiaoyu@163.com。
