丹红注射液与长春西汀联合治疗缺血性脑血管病的综合评价

摘要

目的:从安全性、有效性、经济性3方面对丹红注射液与长春西汀联合治疗缺血性脑血管病进行综合评价与分析.方法:应用Meta分析方法和成本-效果法,对纳入的10篇文献进行综合分析.结果:根据纳排标准,共纳入10篇文献,953例患者,Meta分析结果显示,观察组较对照组疗效明显[OR=3.67,95%CI(2.45,5.51),P<0.01],能够明显改善神经功能缺损评分[MD=-3.17,95%CI(-4.89,-1.44),P<0.01],明显降低hs-CRP水平[MD=-1.57,95%CI(-2.92,-0.22),P<0.01]及IL-6水平[MD=-1.11,95%CI(-1.72,-0.49),P<0.01].不良反应率2组患者比较较[OR=0.62,95%CI(0.24,1.63),P=0.33]差异无统计学意义(P>0.05).成本-效果法结果显示:对照组成本效果比较观察组低(C/E=134.35~201.52、200.38~312.66),增量成本效果比(△C/△E),即每增加一个单位效果,观察组需多增加成本341.88~1 171.07元.结论:联合应用丹红注射液和长春西汀在治疗效果方面优于对照组,同时未增加不良反应发生率,但从经济学方面考虑,联用所用成本较高,提示在临床应结合患者的情况选择用药方案.%Objective: To evaluate the Danhong combined with Vinpocetine for cerebrovascular diseases in terms of efficacy, safety and economy.Methods: A total of 11 articles were analyzed by meta-analysis and cost-effect method.Results: According to the inclusive and exclusive criteria, 10 articles (953 patients) were included.Meta-analysis showed that the treatment group had significant effect [OR=3.67, 95%CI (2.45, 5.51), P<0.00001], the NIHSS was improved [MD=-3.17, 95%CI (-4.89,-1.44),P<0.01] and the level of hs-CRP was reduced [MD=-1.57,95%CI (-2.92,-0.22),P<0.01] and IL-6 [MD=-1.11, 95%CI(-1.72,-0.49), P<0.01].There was no significant difference in the adverse reaction rate between the two groups [OR=0.62, 95%CI(0.24,1.63), P=0.33].The cost of the control group was lower than that of the treatment group (C/E=134.35~201.52,200.38~312.66).For each additional unit effect, the cost of the treatment group was higher (△C/△E=341.88~1 171.07).Conclusion: The effect of Danhong injection combined with Vinpocetine in the treatment is superior to that of the control group, without higher incidence of adverse reactions.From the economic point of view, the combination treatment has higher cost, suggesting that the clinical selection and medication plan should depend on patients′ reality and condition.