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目的探讨丹参酮ⅡA治疗缺血性脑卒中的疗效及其成本—效果比,为临床合理用药提供经济学依据。方法收集符合纳入标准的155名缺血性脑卒中患者,按随机数字表随机分为丹参酮ⅡA组(77例)和尼莫地平组(78例),进行同期盲法试验3周,观察治疗前后缺血性脑卒中患者的症状、体征和颅脑CT检查结果的变化,并计算治疗的总成本,评价成本—效果比。结果丹参酮ⅡA组和尼莫地平组患者症状和体征及颅脑CT检查均有明显改善,总有效率分别为74.02%和71.79%,两组疗效比较无统计学意义。两组治疗后神经功能缺损评分均显著降低(P<0.05),且丹参酮ⅡA组显著低于尼莫地平组(P<0.05)。丹参酮ⅡA组不良反应发生率为9.09%,显著低于尼莫地平组26.92%(P<0.05)。丹参酮ⅡA组治疗成本—效果比2 490.38元(总成本184 338元/总有效率74.02%),低于尼莫地平组8 259.65元(总成本592 960.56元/总有效率71.79%)。结论丹参酮ⅡA治疗缺血性脑卒中的效果与尼莫地平近期疗效相当,不良反应低,有经济学价值。
Objective To investigate the efficacy and cost-effectiveness of tanshinone ⅡA in the treatment of ischemic stroke, and provide an economic basis for clinical rational drug use. Methods A total of 155 ischemic stroke patients who met the inclusion criteria were enrolled and randomized into two groups: Tanshinone ⅡA group (n = 77) and nimodipine group (n = 78). Blinded for 3 weeks, Patients with ischemic stroke symptoms, signs and craniocerebral CT findings changes, and calculate the total cost of treatment, evaluation of cost-effectiveness ratio. Results The symptoms and signs of patients with tanshinone ⅡA and nimodipine group and brain CT examination were significantly improved, the total effective rate was 74.02% and 71.79%, respectively. There was no significant difference between the two groups in curative effect. Neurological deficit scores of both groups were significantly decreased (P <0.05), and tanshinone ⅡA group was significantly lower than that of nimodipine group (P <0.05). Tanshinone ⅡA group adverse reaction rate was 9.09%, significantly lower than the nimodipine group 26.92% (P <0.05). Tanshinone ⅡA treatment cost-effect ratio of 2 490.38 yuan (total cost of 184 338 yuan / total effective rate of 74.02%), lower than the nimodipine group 8 259.65 yuan (total cost of 592 960.56 yuan / total efficiency of 71.79%). Conclusion The efficacy of tanshinone Ⅱ A in the treatment of ischemic stroke is similar to that of nimodipine in short term, with low adverse reactions and economic value.