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血塞通注射液治疗中风的快速卫生技术评估
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张碧华 ,邵 晖 ,叶爱军 ,杨莉萍 [1.北京医院药学部/国家老年医学中心/中国医学科学院老年医学研究院/
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北京市药物临床风险与个体化应用评价重点实验室(北京医院),北京 100730;2.北京市宣武中医医院审计
科,北京 100050]
中图分类号 R972;R956 文献标志码 A 文章编号 1001-0408(2023)01-0097-05
DOI 10.6039/j.issn.1001-0408.2023.01.19
摘 要 目的 利用快速卫生技术评估(rHTA)方法评估血塞通注射液治疗中风的有效性、安全性和经济性,为临床合理用药提供
参考。方法 检索万方医学网、中国生物医学文献数据库、中国知网、PubMed、Cochrane Library、Embase等数据库以及国际卫生技
术评估网络、国际卫生技术评估协会等网站,对血塞通注射液治疗中风的HTA报告、Meta分析/系统评价、药物经济学研究等资料
进行汇总分析。结果 共纳入29篇文献,其中14篇为Meta分析/系统评价、15篇为药物经济学研究,未检索到HTA报告。Meta分
析/系统评价结果显示,血塞通注射液治疗中风在提高总有效率、改善临床症状及相关量表评分等方面与空白对照组及部分药物
对照组相比具有一定优势。安全性研究显示,血塞通注射液不良反应以过敏样反应为主。药物经济学评价的结果差异较大,可能
与各项研究之间时间跨度较长、部分药物价格有所调整相关。结论 血塞通注射液治疗中风有助于提高临床疗效,改善评价指标,
但存在部分严重不良反应,且与部分化学药相比经济性并不占优势。
关键词 血塞通注射液;中风;药物经济学;快速卫生技术评估
Rapid health technology assessment of Xuesaitong injection in the treatment of stroke
ZHANG Bihua ,SHAO Hui ,YE Aijun ,YANG Liping [1. Dept. of Pharmacy, Beijing Hospital/National Center
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of Gerontology/Institute of Geriatric Medicine, Chinese Academy of Medical Sciences/Beijing Key Laboratory of
Assessment of Clinical Drugs Risk and Individual Application(Beijing Hospital), Beijing 100730, China;
2. Dept of Audit,Beijing Xuanwu Hospital of Traditional Chinese Medicine,Beijing 100050,China]
ABSTRACT OBJECTIVE To evaluate the efficacy, safety and economical efficiency of Xuesaitong injection in the treatment of
stroke by rapid health technology assessment,so as to provide evidence for clinical rational drug use. METHODS Retrieved from
Wanfang database, CBM, CNKI,PubMed,Cochrane Library,Embase, INAHTA and HTAI databases or organization websites,
health technology assessment (HTA) reports, meta-analysis/systematic reviews and pharmacoeconomic studies related to Xuesaitong
injection in the treatment of stroke were summarized and analyzed. RESULTS A total of 29 pieces of literature were included.
Among them, 14 studies were conducted on meta-analysis/systematic reviews,15 studies were conducted on pharmacoeconomics,
HTA was not obtained. The results of meta-analysis/systematic reviews showed that Xuesaitong injection had certain advantages for
stroke in improving the total effective rate, clinical symptoms and related scale scores compared with blank control group and some
drug control groups. Safety studies had shown that the adverse reactions of Xuesaitong injection were mainly allergic-like reactions.
The results of pharmacoeconomic evaluation are quite different, which may also be related to the long time span among various
studies and the adjustment of some drug prices. CONCLUSIONS Xuesaitong injection in the treatment of stroke is helpful to
improve the clinical efficacy and evaluation indexes, but there are some serious adverse reactions, and it is not economically
superior to some chemical drugs.
KEYWORDS Xuesaitong injection; stroke; pharmacoeconomics; rapid health technology assessment
中风属中医“风劳鼓膈”四大顽症之一,涵盖了西医 南(2018)》就提到中医药对于急性缺血性脑卒中的治疗
[3]
学的脑梗死、脑出血、短暂性脑缺血发作及蛛网膜下腔 作用,指出中成药能有效改善神经功能缺损 。血塞通
[1]
出血等多种脑血管病 。传统中医药治疗脑血管病主要 注射液是由三七总皂苷制成的中药注射剂,具有活血祛
是基于通经活络、活血化瘀原则,具有悠久的历史并积 瘀、通脉活络的功效,收载于《国家基本医疗保险、工伤
[2]
累了丰富的临床经验 。《中国急性缺血性脑卒中诊疗指 保险和生育保险目录》(2019年版,甲类品种)和《国家基
本药物目录》(2018年版),并被《中国脑梗死中西医结合
Δ 基金项目 北 京 市 中 医 药 科 技 发 展 资 金 资 助 项 目(No. JJ-
诊治指南(2017)》 、《中西医结合脑卒中循证实践指南
[1]
2020-32)
[2]
(2019)》 推荐(证据级别均为C级),在临床上广泛用于
*第一作者 主任药师。研究方向:中药临床药学。E-mail:
[4]
zhangbihua06@163. com 中风及短暂性脑缺血发作等危急重症的治疗 。随着我
中国药房 2023年第34卷第1期 China Pharmacy 2023 Vol. 34 No. 1 · 97 ·