目的:系统评价恩替卡韦与阿德福韦酯治疗慢性乙肝的疗效。方法:检索2015年5月1日以前恩替卡韦与阿德福韦酯治疗慢性乙肝的随机对照试验,评价纳入研究的文献质量,提取文献有效资料,用Rev Man 5.3软件进行Meta分析。结果:检索到恩替卡韦与阿德福韦酯治疗各种类型慢性乙肝的文献共46篇,其中英文1篇,中文45篇。Meta分析结果显示恩替卡韦治疗各类慢性乙型肝炎的乙肝病毒DNA阴转率和ALT复常率高于阿德福韦酯。结论:本研究显示恩替卡韦治疗慢性乙肝效果优于阿德福韦酯,但由于存在一定偏倚,更可靠的结论需要更多高质量的多中心随机双盲对照试验的证据支持。
Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance（2009） was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the medical expenses. In this study, the influence of the list adjustment on drug utilization was investigated. With the comparison between inpatients＇ use of drugs before and after adjustment of Basic Medical Insurance Drug List, we classified the drugs adjusted in national list into six categories： class A to class B, class B to class A, class A to class C, class B to class C, class C to class A, and class C to class B（class A referring to overall insured drugs, class B referring to partial reimbursement drugs, class C referring to self-funded drugs in China）, and drug utilization and expenditure were analyzed with time series model. We analyzed the overall expenditure and average expenditure per 10 000 people based on the comparison before and after the adjustment of 2009 Basic Medical Insurance Drug List. The drug expenditure from class A to class B was decreased by 13.87% of overall expenditure and 16.37% of average expenditure per 10 000 people, and it was decreased by 38.74% and 48.03% from class A to class C; respectively, the drug expenditure from class B to class A was increased by 74.12% and 94.52%, while it was reduced by 19.79% and 14.52% from class B to class C; expenditure declined by 31.77% and 36.22% from class C to class A, and expenditure was increased by 12.42% and 22.05% from class C to class B, respectively, both were lower than before. The adjustment of National Basic Medical Insurance Drug List reduced the overall drug expenditure.
