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·药物经济学·

异甘草酸镁预防胃癌化疗药物致肝损伤的药物经济学评价 Δ

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任发燕 ，王 超 ，谭喜莹，王海丹（南京中医药大学附属医院药学部，南京 210029）
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中图分类号 R956；R975 .5 文献标志码 A 文章编号 1001-0408（2020）13-1613-05
DOI 10.6039/j.issn.1001-0408.2020.13.13
摘 要 目的：评价异甘草酸镁预防胃癌化疗药物致肝损伤的药物经济学，为临床合理选用保肝药提供参考。方法：回顾性收集
2018年1月－2020年2月我院200例住院患者的病历，分为A组（预防性使用异甘草酸镁，50例）、B组（预防性使用异甘草酸镁联
合中药协定方，50例）、C组（预防性使用多烯磷脂酰胆碱，50例）和D组（未预防性使用保肝药，50例）。比较4种方案预防肝损伤
的效果（总有效率），采用最小成本法和成本-效果分析法进行经济学评价，同时进行敏感性分析。结果：A、B、C、D组患者总有效
率分别为94.00％、96.00％、82.00％、72.00％，A组和B组患者的总有效率比较差异无统计学意义（P＞0.05），但显著高于C组和D
组（P＜0.05）；C组患者总有效率显著高于D组（P＜0.05）。A、B、C、D组的成本分别为1 936.70 、2 086.96、1 800.91、2 975.42元，采
用最小成本法比较A组和B组方案，结果A组方案更经济；采用成本-效果法比较C组和D组方案，结果C组方案更经济；采用成本-
效果法比较A组和C组方案，结果两组方案的成本-效果比分别为2 060.32、2 196.23，A组方案的增量成本-效果比为1 131.58，A组方
案更经济。 敏感性分析支持上述结果。结论：异甘草酸镁预防胃癌化疗药物致肝损伤的成本-效果优于异甘草酸镁联合中药协定
方、多烯磷脂酰胆碱和未预防性使用保肝药，更具经济学优势。
关键词 异甘草酸镁；药物性肝损伤；胃癌；化疗药物；药物经济学

Pharmacoeconomic Evaluation of Magnesium Isoglycyrrhizinate Preventing Liver Damage Induced by
Chemotherapeutic Drugs for Gastric Cancer
REN Fayan，WANG Chao，TAN Xiying，WANG Haidan（Dept. of Pharmacy，the Affiliated Hospital of Nanjing
University of TCM，Nanjing 210029，China）

ABSTRACT OBJECTIVE：To evaluate pharmacoeconomics of magnesium isoglycyrrhizinate preventing liver damage induced by
chemotherapeutic drugs for gastric cancer，and to provide reference for rational use of liver-protecting drugs. METHODS：Totally
200 inpatient medical records were collected from our hospital retrospectively during Jan. 2018-Feb. 2020，and then divided into
group A（prophylactic use of magnesium isoglycolate，50 cases），group B（prophylactic use of magnesium isoglycolate combined
with TCM prescriptions， 50 cases）， group C （prophylactic use of polyene phosphatidylcholine， 50 cases） and group D
（non-prophylactic use of liver-protection drugs，50 cases）. The effects（total response rate）of four plans preventing liver damage
were evaluated. Pharmacoeconomic evaluation was analyzed by cost-minimization analysis and cost-effectiveness method，
sensitivity analysis was carried out at the same time. RESULTS：Total response rates of group A，B，C and D were 94.00％，
96.00％，82.00％ and 72.00％. The total response rates of group A and B had no statistical significance（P＞0.05），but were
significantly higher than those of group C and D（P＜0.05）；total response rate of group C was significantly higher than that of
group D （P＜0.05）. The costs of groups A， B， C and D were 1 936.70， 2 086.96， 1 800.91， 2 975.42 yuan. The
cost-minimization analysis was used to compare the therapeutic plan of group A and B，and plan of group A was more economical.
The cost-effectiveness method was used to compare therapeutic plan between group C and D，and the plan of group C was more
economical. The cost-effectiveness method was used to compare therapeutic plan between group A and C，and the cost-effectiveness
ratio of 2 groups were 2 060.32 and 2 196.2 3，incremental cost-effectiveness ratio was 1 131.58，and the plan of group A was
more economical. Above conclusion were supported by the results of sensitivity analysis. CONCLUSIONS：The cost-effectiveness
of magnesium isoglycyrrhizinate preventing liver damage induced by chemotherapeutic drugs for gastric cancer is better than
magnesium isoglycyrrhizinate combined with TCM prescription， polyene phosphatidylcholine and non-prophylactic use of
liver-protecting drugs，showing economical advantage.
KEYWORDS Magnesium isoglycyrrhizinate；Drug-induced liver damage；Gastic cancer；Chemotherapeytic drug；Pharmacoeconomics
Δ 基金项目：国家自然科学基金资助项目（No.81804131）；江苏省
药学会科研项目（No.Q2018015）
[1]
我国胃癌的发病率和病死率均较高 ，2018 年调查
＊主管药师。研究方向：临床药学。电话：025-86620113。E-
研究结果显示，在发病率较高的10种癌症中胃癌发病率
mail：renfayan88@163.com
# 通信作者：副主任药师，硕士。研究方向：中药学。电话：025- 和病死率分别为 15.82％和 17.70％，在各类肿瘤的发病
[2]
86620113。E-mail：wangchao_mail@126.com 率与病死率中均排在第 2 位 。目前，胃癌治疗多以化
中国药房 2020年第31卷第13期 China Pharmacy 2020 Vol. 31 No. 13 ·1613 ·