1.Clinical Study on Sequential Therapy of Ginkgo biloba Extract Preparation for Acute Cerebral Infarction in Elderly Patients
Weisen DONG ; Jie LI ; Hejun CHEN ; Fang HE ; Yongjian CUI
China Pharmacy 2017;28(11):1499-1502
OBJECTIVE:To observe clinical effects and safety of sequential therapy of Ginkgo biloba extract preparation for elderly acute cerebral infarction,and to evaluate its pharmacoeconomics. METHODS:Totally 98 patients with acute cerebral infarc-tion selected from neurology department of our hospital during Aug. 2014-Aug. 2015 were divided into control group and test group according to random number table,with 49 cases in each group. Both groups received routine therapy of antiplatelet aggregation, microcirculation improvement. Control group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for consecutive 21 d. Test group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for 7-10 d;and then given G. biloba tablet instead,1 tablet,po ,tid,for 21 d in total. Clinical efficacies of 2 groups were compared as well as ESS score,ADL score,blood flow in-dexes and blood lipid indexes before and after treatment,and adverse drug reaction. Cost-minimization analysis was used for phar-macoeconomic evaluation. RESULTS:After treatment,total response rate of control group and test groups were 87.23% and 83.33%,without statistical significance (P>0.05). Before treatment,there was no statistical significance in ESS score,ADL score,blood flow indexes and blood lipid indexes between 2 groups (P>0.05). After treatment,ESS score and ADL score of 2 groups were increased significantly,and whole blood viscosity,plasma viscosity,hematocrit,fibrinogen content,TC and TG were decreased significantly;there was statistical significance with before treatment(P<0.05);there was no statistical significance be-tween 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The average cost of control group and test group were (7060.9 ± 234.8) yuan and (5800.7 ± 149.5) yuan,with statistical significance (P<0.01). CONCLUSIONS:The sequential therapy of G. biloba extract preparation is similar to intravenous dirpping in the treatment of elderly acute cerebral infarction in therapeutic efficacy and safety. The sequential therapy is better in economics field.
2.Study on ADR Centralized Monitoring of Xuebijing Injection in Our Hospital
Fang HE ; Hejun CHEN ; Xiao ZHANG ; Shixue HE ; Jie LI ; Weisen DONG
China Pharmacy 2017;28(29):4089-4092
OBJECTIVE:To explore the incidence,clinical manifestations and influential factors of ADR induced by Xuebi-jing injection,and to provide reference for safe and rational use of it. METHODS:The inpatients who used Xuebijing injection in our hospital during Jan. 2012 to Dec. 2016 was registered and monitored centrally,and analyzed statistically in respects of clinical characteristics,occurrence time of ADR,clinical manifestation,outcome,etc.RESULTS:A total of 3 300 patients records were in-cluded,involving 81 ADR cases with incidence of 2.45%. There was no correlation between ADR and gender. The incidence of ADR was in high level in the patients with age over 60 years(6.53%),history of allergy(72.84%),original diseases as respirato-ry disease(3.33%),blood system disease(3.11%)and central nervous system disease(3.03%),and receiving combination of TCM injection(34.57%),antibiotics(25.93%)and immune enhancer(14.81%). Single-day culmulative amount with no more than 50 mL had relatively higher proportion(36.67%),and there was no statistical significance in the ADR with different sin-gle-day culmulative amounts(P>0.05). 38.27% of ADR occurred within 30 min after first medication. Organs/systems involved in ADR were mainly skin and its appendants(37.04%),cardiovascular system(19.75%)and gastrointestinal system(14.81%). To-tally 15 cases had severe ADR,which were mainly anaphylactic shock(33.33%,5/15)and systemic rash(20.00%,3/15). All ADR were recovered after drug withdrawal or symptomatic treatment. CONCLUSIONS:ADR induced by Xuebijing injection are mainly anaphylactic type. The incidence of ADR is higher in patients with primary respiratory disease,blood system disease,drug combination,allergic history and advanced age. The part of them are not mentioned in drug package inserts.Manufacturers are sug-gested to collect ADR information and improve drug package insets in time.
3.Cost-effectiveness Analysis of Cefazolin Sodium Pentahydrate versus Cefazolin Sodium in the Treatment of Bacterial Infection
Jie LI ; Hejun CHEN ; Weisen DONG ; Fenglei LI ; Lidan WANG
China Pharmacy 2017;28(29):4050-4053
OBJECTIVE:To compare the cost-effectiveness of cefazolin sodium pentahydrate versus cefazolin sodium in treat-ment of bacterial infection,and to provide reference for rational drug use in the clinic.METHODS:In retrospective study,207 bac-terial infection patients receiving cefazolin sodium pentahydrate or cefazolin sodium were selected from our hospital during Nov. 2014 to Dec. 2015,including 109 cases in cefazolin sodium pentahydrate group and 98 cases in cefazolin sodium group. Both groups received relevant medicine 2 g,bid,ivgtt,within 7 d. The clinical efficacies,bacteriological efficacies and safety of 2 groups were compared,and pharmacoeconomics of 2 therapy plans were evaluated.RESULTS:The clinical response rates of cefazo-lin sodium pentahydrate group and cefazolin sodium group were 89.91% and 74.49%,with statistical significance(P<0.05);bac-terial clearance rates were 76.32% and 72.13%,with no statistical significance(P>0.05). No drug-related ADR occurred in 2 groups during the treatment. Total shot-term(7 d)cost of cefazolin sodium pentahydrate group and cefazolin sodium group respec-tively were 4 391.43 yuan and 3 396.19 yuan. Using clinical response rate as effect index,cost-effectiveness ratio of them were 48.84 and 45.59,and incremental cost-effectiveness ratio was 64.55,which was lower than per capita GDP of Hengshui city. The sensitivity analysis results were in agreement with the cost-effectiveness analysis. CONCLUSIONS:Under the current economic sit-uation of Hengshui city,cefazolin sodium pentahydrate has cost-effectiveness advantage in the treatment of bacterial infection than cefazolin sodium.