五酯片与他克莫司联合应用对肾移植患者的临床疗效及药物经济学评价

目的评价服用他克莫司（FK506）的同种异体肾移植患者术后应用五酯片后的临床疗效及药物经济学效果。方法65例肾移植术后患者服用他克莫司（FK506胶囊）4周，根据治疗方案分成2组，I组加用五酯片，Ⅱ组则未使用五酯片。分组后，FK506起始剂量同分组前，以后依据其血药浓度调整用量以达到相同的FK506谷浓度。用药物经济学成本-效果分析方法对2种方案进行比较。结果I组和Ⅱ组的成本分别为42838．00圆和46461．00圆，有效率分别为90．91％和93．75％，成本效果比分别为471．21和495．58；Ⅱ组对于I组的增量成本效果比为1275．70，不良反应发生率分别为21．21％及18．75％，差异无统计学意义。结论应用五酯片组在达到相同FK506治疗窗情况下，FK506用量减少，药物费用明显降低，而并不增加急性排斥反应的发生率。

Clinical effect and pharmacoeconomic evaluation of Wuzhi tablet and tacrolimus coadministration after renal transplantation

A/M To investigate the clinical efficacy and phannacoeconomics of Wuzhi tablets and tacrolimus coadministration after renal transplantation. METHODS Sixty-five patients with renal transplantation took tacrolimus as part of immunosuppression for 4 weeks. After that, they were divided into 2 groups, group I with Wuzhi tablets and group II without Wuzhi tablets. Then the adjustment of tacrolimus dose was taken in group I and II aecordding to their blood concentration to achieve the same therapeutic window. The pharmacoeconomic cost-effectiveness analysis was used to compare these two programs. RESULTS The costs in group I and group II were 42 838.00 yuan and 46 461.00 yuan, and the effective rates were 90.91% and 93.75%, respectively. The cost-effective ratios were 471.21/unit effectiveness and 495.58/unit effectiveness, respectively. It costed 1 275.70 more in group II than in group I. There were no statistical differences of the adverse drug reactions in 2 groups （21.21% and 18.75 % ）. CONCLUSION Tacrolimus co-administration with Wuzhi tablets will decrease tacmlimus doses and costs while remain similar treatment efficiency with less adverse drug reactions.