1.中国中医科学院广安门医院济南医院/济南市中医医院,山东省济南市中区共青团路76号,250012
2.清华大学玉泉医院/清华大学中西医结合医院
3.中国中医科学院中医临床基础医学研究所
ketizu2018@163.com
收稿:2025-01-14,
修回:2025-06-30,
纸质出版:2025-10-02
移动端阅览
秦英,朱晓霞,王凤晨等.头痛宁胶囊治疗偏头痛的临床证据总结与评价[J].中医杂志,2025,66(19):2014-2022.
QIN Ying,ZHU Xiaoxia,WANG Fengchen,et al.Summary and Evaluation of Clinical Evidence for Toutongning Capsules (头痛宁胶囊) in Treatment of Patients with Migraine[J].Journal of Traditional Chinese Medicine,2025,66(19):2014-2022.
秦英,朱晓霞,王凤晨等.头痛宁胶囊治疗偏头痛的临床证据总结与评价[J].中医杂志,2025,66(19):2014-2022. DOI: 10.13288/j.11-2166/r.2025.19.009.
QIN Ying,ZHU Xiaoxia,WANG Fengchen,et al.Summary and Evaluation of Clinical Evidence for Toutongning Capsules (头痛宁胶囊) in Treatment of Patients with Migraine[J].Journal of Traditional Chinese Medicine,2025,66(19):2014-2022. DOI: 10.13288/j.11-2166/r.2025.19.009.
目的
2
开展头痛宁胶囊治疗偏头痛的临床证据总结与评价,为临床合理用药与国家医疗决策等提供参考。
方法
2
基于文献资料、相关数据平台、临床调查等收集到相关信息,通过专家会议法投票获得多准则决策分析模型准则层的维度和指标层因素的相关权重,利用CSC v2.0软件从安全性、有效性、经济性、创新性、适宜性、可及性6个维度结合中医药特色对头痛宁胶囊进行综合评分与分级评价。
结果
2
安全性:依据监测到的不良反应、上市前的急毒和长期毒性试验、上市后企业的药物警戒工作情况,综合得出头痛宁胶囊不良反应风险分级为B,认为安全性良好。有效性:根据Meta分析结果,头痛宁胶囊治疗偏头痛的有效率高于西药相,综合评价分级为B,表明其有效性好。经济性:药物经济学研究显示,与盐酸氟桂利嗪胶囊相比,头痛宁胶囊治疗更具有成本-效果优势,综合评价分级为B,表示有较高的经济价值,但证据质量有待提高。创新性:头痛宁胶囊不仅具有临床创新,企业自动化生产线方面也进行了创新,证据评价为B级,创新性较好,证据充分。适宜性:头痛宁胶囊用法简单,患者依从性高,问卷显示临床医师、药师、护士及具有用药经验的患者对其均有较好的适宜性。可及性:头痛宁胶囊每疗程费用占城镇居民和农村居民可支配收入比例较低,全国各省市有售,可获得性好,综合评价为A级,可及性好。中医药特色:头痛宁胶囊具有熄风涤痰、逐瘀止痛之功,用于治疗偏头痛,具有充分的人用经验,特色类别为B级,中医药特色较明显。综合上述6+1维度评价结果,认为头痛宁胶囊总体评价为临床价值较好,具有一定的中医药特色。
结论
2
头痛宁胶囊具有较好的临床价值,建议按程序、有条件地转化为基本临床用药管理的相关政策。
Objective
2
To comprehensively evaluate the clinical application value of
Toutongning Capsules
(头痛宁胶囊) in the treatment of migraine, so as to provide evidence for clinical rational use and national medical decision-making.
Methods
2
Relevant information was collected from literature, data platforms, and clinical investigations, and dimensions of the criteria and relative weights assigned to the indicator-level factors of the multi-criteria decision ana-lysis (MCDA) model were determined through expert panel voting. Using CSC v2.0 software,
Toutongning Capsules
were comprehensively scored and graded across six dimensions, including safety, effectiveness, economy, innovation, suitability and accessibility, in combination with their characteristics in traditional Chinese medicine (TCM).
Results
2
Safety:Based on the currently monitored adverse reactions, pre market acute and long-term toxicity tests, and post market drug surveillance by the company, it is concluded that the risk of adverse reactions of
Toutongning Capsules
is graded B, indicating good safety. Effectiveness: According to the meta-analysis results, compared to western medicine,
Toutongning Capsules
exhibit a higher effective rate than chemical medicine in the treatment of migraines. The comprehensive evaluation rating is B, indicating good effectiveness. Economy: Pharmacoeconomic studies indicate that compared to flunarizine hydrochloride capsules,
Toutongning Capsules
offer greater cost-effectiveness. The comprehensive evaluation rating is B, suggesting high economic value, though the quality of evidence requires improvement. Innovation:
Toutongning Capsules
not only exhibit clinical innovation but also demonstrate innovation in their automated production lines. The evidence is rated as B, indicating strong innovation with sufficient supporting evidence. Suitability: The usa
ge of
Toutongning Capsules
is simple, with high patient compliance. The questionnaire results indicate that clinicians, pharmacists, nurses and patients with medication experience all rate its suitability as good. Accessibility: The cost of each treatment course of
Toutongning Capsules
represents a relatively low percentage of the disposable income of both urban and rural residents. They are available for sale in various provinces and cities across the country, with good accessibility and comprehensively evaluated as A. TCM characteristics:
Toutongning Capsules
are effective in extinguishing wind, clearing phlegm, removing blood stasis, and alleviating pain, which can be used to treat migraines and has a long history of human use. This is rated as B level, indicating a relatively distinct TCM features. Based on the above 6+1 dimensional evaluation,
Toutongning Capsules
demonstrate favorable clinical value.
Conclusion
2
It is recommended that, following appropriate procedures and under certain conditions, they be incorporated into relevant policies for the management of essential clinical medications.
Headache Classification Committee of the International Headache Society (IHS) . The international classification of headache disorders, 3rd edition [J]. Cephalalgia , 2018 , 38 ( 1 ): 1 - 211 .
郭承承 . 偏头痛的药物治疗及作用机制 [J]. 医学信息 , 2022 , 35 ( 9 ): 81 - 83 .
李聪 , 胡纪可 , 郭耀光 , 等 . 川芎茶调散加减配合针刺治疗偏头痛急性发作期(风痰阻络证)及对神经血管源性活性介质的影响 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 24 ): 122 - 127 .
卢健锋 , 杨璧璘 , 李晓琼 , 等 . 天麻钩藤饮治疗肝阳上亢型偏头痛疗效的Meta分析 [J]. 湖南中医杂志 , 2020 , 36 ( 9 ): 133 - 135 .
贾敏 , 鲁喦 , 张允岭 , 等 . 口服中成药治疗偏头痛的网状Meta分析 [J]. 中国中药杂志 , 2020 , 45 ( 21 ): 5068 - 5082 .
中华中医药学会 . 中医内科临床诊疗指南 头痛 [M]. 北京 : 中华中医药学会 , 2019 .
国家卫生健康委药物政策与基本药物制度司 . 药品临床综合评价管理指南(2021年版试行) [EB/OL].( 2021-07-28 )[ 2024-06-10 ]. https://www.nhc.gov.cn/yaozs/c100097/202107/d2a45e6ae041423f950b3865e43f5ef6.shtml https://www.nhc.gov.cn/yaozs/c100097/202107/d2a45e6ae041423f950b3865e43f5ef6.shtml .
戴泽琦 , 徐思敏 , 吴雪 , 等 . 多准则决策分析用于中成药临床综合评价的建议 [J]. 中国中药杂志 , 2022 , 47 ( 12 ): 3155 .
张强 , 王志飞 , 谢雁鸣 . 前列舒通胶囊治疗慢性前列腺炎湿热瘀阻证的临床综合评价 [J]. 中医杂志 , 2022 , 63 ( 21 ): 2037 - 2045 .
TSINTIS P , LA MACHE E . CIOMS and ICH initiatives in pharmacovigilance and risk management: overview and implications [J]. Drug Saf , 2004 , 27 ( 8 ): 509 - 517 .
HOWARD B , HELFAND M , SCHUNEMANN HJ , et al . GRADE 指南:Ⅲ.证据质量分级 [J]. 中国循证医学杂志 , 2011 , 11 ( 4 ): 451 - 455 .
王瑞平 . 临床研究规范设计PICO原则 [J]. 上海医药 , 2022 , 43 ( 3 ): 67 - 72 .
Critical Appraisal Skills Programme . 12 questions to help you make sense of economic evaluations [EB/OL].( 2004-05-18 ) [ 2024-07-13 ]. https://med-fom-emerg.sites.olt. ubc.ca/files/2014/02/CASP-Economic-Evaluation-Checklist.pdf https://med-fom-emerg.sites.olt.ubc.ca/files/2014/02/CASP-Economic-Evaluation-Checklist.pdf .
席俊羽 , 魏仲义 , 张强 , 等 . 喉咽清口服液治疗急性咽炎的临床综合评价 [J]. 中国中药杂志 , 2024 , 49 ( 1 ): 279 - 284 .
BROUWERS MC , KHO ME , BROWMAN GP , et al . AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care [J]. CMAJ , 2010 , 182 ( 18 ): E839 - E842 .
SHEA BJ , REEVES BC , WELLS G , et al . AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both [J]. BMJ , 2017 , 358 : j4008 . doi: 10. 1136/bmj.j4008 http://dx.doi.org/10.1136/bmj.j4008 .
STERNE JAC , SAVOVIĆ J , PAGE MJ , et al . RoB 2: a revised tool for assessing risk of bias in randomised trials [J]. BMJ , 2019 , 366 : l4898 . doi: 10.1136/bmj.l4898 http://dx.doi.org/10.1136/bmj.l4898 .
MOHER D , SCHULZ KF , ALTMAN DG . The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials [J]. Lancet , 2001 , 357 ( 9263 ): 1191 - 1194 .
ELEZBAWY B , FASSEEH AN , NÉMETH B , et al . A multicriteria decision analysis (MCDA) tool to purchase implantable medical devices in Egypt [J]. BMC Med Inform Decis Mak , 2022 , 22 ( 1 ): 289 .
吉萌萌 , 荆志伟 , 赵永烈 , 等 . 头痛宁胶囊治疗偏头痛的Meta分析 [J]. 中药药理与临床 , 2018 , 34 ( 5 ): 121 - 124 .
叶树君 , 华赛美 , 何佳 . 氟桂利嗪联合头痛宁治疗偏头痛临床疗效及对血清TNF-α、ICAM-1和CGRP水平的影响 [J]. 中华中医药学刊 , 2022 , 40 ( 8 ): 151 - 153 .
马伊莎 . 头痛宁联合盐酸氟桂利嗪对偏头痛患者症状改善及脑血流速度的影响 [J]. 实用中西医结合临床 , 2023 , 23 ( 10 ): 27 - 29,40 .
田甜 , 李世容 , 胡晓 , 等 . 头痛宁胶囊联合氟桂利嗪治疗偏头痛有效性及安全性的临床随机对照试验的Meta分析 [J]. 现代预防医学 , 2018 , 45 ( 13 ): 2481 - 2490 .
刘婷 , 沈飞飞 , 韦俊超 , 等 . 头痛宁对电刺激三叉神经节大鼠脑膜血流与CGRP的影响 [J]. 中国疼痛医学杂志 , 2010 , 16 ( 4 ): 220 - 223 .
朱博驰 , 姚刚 , 于挺敏 , 等 . 头痛宁胶囊对偏头痛大鼠中脑P物质mRNA表达的影响 [J]. 中国疼痛医学杂志 , 2012 , 18 ( 10 ): 623 - 627 .
符艳松 . 头痛宁对偏头痛模型大鼠血浆β-EP含量及脑组织β-EP、c-fos、c-jun、5-HT表达的影响 [D]. 唐山 : 河北联合大学 , 2011 .
张鑫 . 头痛宁胶囊和氟桂利嗪治疗偏头痛的成本-效果观察 [J]. 中国社区医师 , 2016 , 32 ( 13 ): 103 - 104 .
张强 , 王志飞 , 谢雁鸣 , 等 . 中成药临床综合评价报告规范 [J]. 中国中药杂志 , 2021 , 46 ( 23 ): 6062 - 6067 .
张强 , 王志飞 , 谢雁鸣 , 等 . 中成药临床综合评价技术规范 [J]. 世界中医药 , 2021 , 16 ( 22 ): 3394 - 3397,3403 .
0
浏览量
0
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号