目的 评价连花清瘟胶囊(颗粒)、金花清感颗粒、宣肺败毒汤、化湿败毒颗粒、清肺排毒汤分别联合西医常规疗法治疗新型冠状病毒肺炎的临床有效性、安全性和经济性.方法 在中国期刊全文数据库、万方数据知识服务平台、中文期刊全文数据库、中国生物医学文献服务系统、Pubmed、Embase、Cochrane Library检索5 种中成药/汤剂分别联合西医常规疗法治疗新型冠状病毒肺炎的随机对照试验(RCT),采用网状Meta分析比较其有效性和安全性,用成本-效果分析法从医疗系统的角度进行经济性评价.结果 本研究纳入 11 篇文献,共计 1735 例患者.网状Meta分析结果显示,在咳嗽消失率、总有效率和核酸转阴率方面,连花清瘟胶囊(颗粒)联合西医常规治疗(以下均称"联合组")效果最好;在CT有效率和不良反应发生率方面,连花清瘟胶囊(颗粒)联合组在所有方案中排第二.经济性评价结果显示,连花清瘟胶囊(颗粒)、金花清感颗粒及宣肺败毒汤联合组的疗程总费用分别为49.42 元、186.90 元和301.00 元,连花清瘟联合组与西医常规治疗相比,每多使1 例患者达到咳嗽消失需要多花费73.76 元;当意愿支付值为 90 元时,连花清瘟胶囊(颗粒)联合组具有经济性的概率为88.8%,当意愿支付值大于90 元时,连花清瘟胶囊(颗粒)联合组具有经济性的概率始终大于西医常规治疗组.结论 连花清瘟胶囊(颗粒)联合西医常规疗法治疗新型冠状病毒肺炎的临床有效性和安全性较好,当意愿支付值较低时,单用西医常规治疗可能更具有经济性;随着意愿支付值的增加,连花清瘟胶囊(颗粒)联合西医常规治疗可能更具有经济性.
Objective To evaluate the efficacy,safety and economy of Chinese patent medicines(Lianhua Qingwen capsules(granules),Jinhua Qinggan granules,Xuanfei Baidu decoction,Huashi Baidu granules,Qingfei Paidu decoction)combined with standard therapy in patients with COVID-19.Methods Randomized controlled trials of the five Chinese patent medicine or decoction combined with standard therapy were searched from EMBASE,PubMed,Cochrane Library,CNKI,WanFang database,CBM and VIP Database.The network meta-analysis were used to compare the efficacy and safety.The cost-effectiveness analysis were used to evaluate economy from Healthcare System perspective.Results A total of 11 literatures were included in this study,including 1735 patients with COVID-19.The results of network meta-analysis showed that in terms of the cough disappearance rate,total effective rate and nucleic acid negative conversion rate,Lianhua Qingwen capsules(granuless)combined with standard therapy(the following are called the"combined group")was the best.In terms of CT improvement rate and safety,Lianhua Qingwen capsule(granule)combined group ranks second in all schemes.The results of economic evaluation show that the cure costs of the Lianhua Qingwen,Jinhua Qinggan and Xuanfei Baidu combined groups were 49.42,186.90,301.00 yuan,respectively.Compared with conventional western medicine treatment group,the Lianhua Qingwen combined group costs 73.76 yuan more to make one more patient reach cough disappearance.When the willing payment value is 90 yuan,the economic probability of Lianhua Qingwen combined group was 88.8%.When the willing payment value is greater than 90 yuan,the economic probability of Lianhua Qingwen combined group is always greater than that of conventional western medicine treatment group.Conclusion Lianhua Qingwen combined group has better efficacy and safety in the treatment of COVID-19.When the willing payment value is low,conventional western medicine alone may be more economical.With the increase of willingness to pay,Lianhua Qingwen combined group may be more economical.
曹世欢;梁婉娴;张丽宁;刘霞;刘春晖;王萍
北京中医药大学循证医学中心,北京 100029北京国铭博思医药科技有限公司,北京 100036
临床医学
连花清瘟胶囊(颗粒);新型冠状病毒肺炎;经济性评价;网状Meta分析
Lianhua Qingwen capsules(granules);COVID-19;Economic evaluation;Network meta-analysis
《中国药物经济学》 2024 (002)
8-16 / 9
10.12010/j.issn.1673-5846.2024.02.002
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