非劣效/等效性界值在中药临床再评价中的应用研究
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摘要
目的:
     探讨非劣效/等效性界值在中药临床再评价临床试验中的作用。
     方法:
     (1)通过理论研究和临床试验,探讨目前中药临床再评价的目的、意义及方法。
     (2)对非劣效/等效性界值在中药临床再评价临床试验中的作用、确定原则及应用方法进行分析研究。
     结果:
     (1)目前中药临床再评价存在的不足之处:试验样本量较小,试验缺乏随机对照,统计学检验存在误差,评价标准不规范,临床定位不清,新的方法技术在中药临床再评价中的应用太少,中药数据库不完善,中药重点剂型再评价未引起足够重视。
     (2)目前从文献检索的结果来看,几乎所有的非劣效/等效性临床试验都没有规定非劣效/等效性界值的取值,造成了其结论只具有统计学意义,未考虑临床意义。
     (3)为了临床试验结果更为可信,具有实际临床意义,必须在试验设计的时候,考虑到非劣效/等效性界值的取值。
     (4)根据设计方案所确定的非劣效性界值为0.1,按证候疗效进行非劣效性检验,FAS(u=5.597,P=0.000)和PP(u=6.388,P=0.000),试验组证候疗效非劣效于对照组;对贫血有效率进行非劣效性检验,FAS(u=4.993,P=0.000)和PP(u=5.317,P=0.000),试验组贫血有效率非劣效于对照组:对月经不调有效率进行非劣效性检验,FAS(u=3.979,P=0.000)和PP(u=4.888,P=0.000),试验组月经不调有效率非劣效于对照组。
     结论:
     (1)中药临床再评价的方法中最重要的是前瞻性多中心随机对照临床试验。
     (2)基于显著性检验得到的的药物疗效统计学结果未考虑临床意义。
     (3)非劣效/等效性界值的应用是统计学结果是否具有临床实际意义的关键。
     (4)非劣效/等效性界值的具体取值,需要慎重的确定,必须在制定试验方案时予以提前确定。
     (5)非劣效/等效性界值的最终确定,必须紧密结合试验病证的临床特征,由相关学科临床专家和统计学家共同认可。
Purpose
     To explore the role of non-inferiority/equivalence value in re-evaluation clinical trials for traditional Chinese medicine.
     Methods
     (1) Through theoretical research and clinical trials to explore the purpose, the clinical significance and evaluation of the current re-evaluation of traditional Chinese medicine.
     (2) To analyze the function, the determining principles and the application of non-inferiority/equivalence value in re-evaluation clinical trials for traditional Chinese medicine.
     Results
     (1)The current clinical re-evaluation of traditional Chinese medicine had some deficiencies:the smaller volume of test samples, the lack of randomized controlled trial, the existence of statistical error, non-standard evaluation criteria, unclear clinical orientation, limited application of the new methods and techniques in clinical re-evaluation of traditional Chinese medicine, little attention to clinical re-evaluation of important Chinese herbal pharmaceutics.
     (2)At present, literature research released that almost all of the non-inferiority /equivalence of clinical trials had not applied non-inferiority/equivalence cutoff values, which lead to the conclusions only have statistical significance. But the clinical significances did not take into account.
     (3)It is necessary to consider the non-inferiority/equivalence value in trials' designs in order to get credible results with more clinical significances.
     (4)According to the program's design, the non-inferiority of the sector value was 0.1. Based on the syndrome effects of non-inferiority test, FAS (u=5.597, P=0.000) and PP (u=6.388, P=0.000), the experimental group had non-inferiority efficacy compared with the control group. For anemia efficient non-inferiority test, FAS (u=4.993, P=0.000) and PP (u=5.317, P=0.000), the effective rate in experimental group had non-inferiority to that of the control group. For irregular menstruation efficient non-inferiority test, FAS (u=3979, P=0.000) and PP (u=4.888, P=0.000), the effective rate in experimental group had non-inferiority to that of the control group.
     Conclusion
     (1)The most important method of clinical re-evaluation of traditional Chinese medicine is forward-looking, multi-center randomized and controlled clinical trials.
     (2)The clinical significances had not been take into account in statistical results of herbals efficacy based on the significance test.
     (3)The application of Non-inferiority/equivalence was a vital factor to decide whether the statistical results have clinical meaning.
     (4)Circumspect consideration should be needed to determine the specific cutoff value of non-inferiority/equivalence. The values must be decided before trials design.
     (5)To determine the ultimate value of non-inferiority/equivalence cutoff, clinical experts of relevant disciplines must draw a common recognition with statisticians according to the clinical features of diseases.
引文
[1]李少丽,王兰明,颜敏.关于在我国建立药品上市后再评价制度的探讨.中国新药杂志;2001,10(4):241-244.
    [2]马伯英.《山海经》中药物记载的再评价.中医药学报;1984, (4):7-9
    [3]工新志,李燕梅.中成药上市后再评价的现状与思考.中国新药杂志;2006,15(18):1517-1519
    [4]程鲁榕.药品呼唤上市后再评价.药物警戒;2005,2(4):220-222
    [5]Fletcher, A. P. Drug safety tests and subsequent clinical experience J. Roy. Soc. Med.1978,71: 693-696.
    [6]Lee,W.M. Drug-induced hepatotoxicityQ. N. Engl.Med.2003,349,474-485.
    [7]Schwarrz, S., Raskin, P., Fonseca, V.&Graveline, J. F. Effect of troglitazone in insulin-treated patients with type Ⅱ diabetes melli-tus (?) N. Engl. J. Med.1998,338, 861-866.
    [8]李一石.新药的临床安全性评价.药物流行病学杂志;2004,13(6):287-289
    [9]严敏,李少丽,吴哗,等.药品上市后再评价工作的现状与思考.中国新药杂志;1999;433-436.
    [10]中国卫生部药品标准及药典考察组.国外药品质量考察报告.药学情报通讯;1988,6(1):3-8
    [11]程鲁榕.药品呼唤上市后再评价.药物警戒;2005,2(4):220-222
    [12]鄢琳,程鲁榕,兰奋.国外药物撤销、限制使用的情况对我国药品评价的启示.中国临床药理学杂志;2002,18(6):470-474
    [13]曾繁典.药品不良反应监测及其研究进展.湖北民族学院学报·医学版;2002,19(1):1-2
    [14]王文,刘力生.大样本多中心心血管病临床实验方法与结果评估.中华心血管病杂志1993;21:309-311.
    [15]朱炳富,任国娟,严炎中.上市药品的再评价.海峡药学;2006,18(2):203-205
    [16]朱永琪.中国药房.1992;3(2):6
    [17]胡大一,杨进刚.应重视上市后药物安全性的循证医学冉评价-罗非昔布召回的意义.中国循证医学杂志,2005,5(2):95
    [18]张石革,宋菲.回顾若干处方药的淘汰史,重视药物的临床再评价.中国医院用药评价与分析;2002,2(4):195-198
    [19]张静,莫玮,周宏灏.药品上市后监测是必需的.英国医学杂志中文版;2005,8(1):60.
    [20]中国卫生部药品标准及药典考察组.国外药品质量考察报告.药学情报通讯;1988,6(1): 3-8
    [21]黄海英.应重视药品上市后的再评价.基层中药杂志;2002,16(4):56-57
    [22]李少兰,王兰明,颜敏.关于在我国建立药品上市后再评价制度的探讨.中国新药杂志;2001,10(4):241-244
    [23]John PA.Ioannidis Improving Safety Reporting from Randomised Trials.Drug Safety,2002;25:77-84
    [24]唐秋瑾,李露西.卫生部组织遴选国家基本药物.中国药事;1993,7(4):262-263
    [25]黄海英.应重视药品上市后的再评价.基层中药杂志;2002,16(4):56-57
    [26]张石革.世界非处方药分类管理制度的现状与市场特点.中国药房;1996,7(2):51
    [27]胡廷熹.药学进展;1996,20(2):108
    [28]吴玉琼.我国非处方药制自议.荆门职业技术学院学报;1999,14(6):78-86
    [29]孙忠实.中国药房;1996,7(3):101
    [30]陈永法,刘平羽,张成绪.建立与完善我国药品再评价体系的研究.西北药学杂志;2005,20(3):131-134
    [31]Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reaction in hospitalized patients:a meta-analysis of prospective studies JAMA 1998; 279; 1200 — 1205.
    [32]李慧芬,翟颖,张学武.北京市西药地方标准品种概况与问题分析.首都医药;1997,4(5):15
    [33]陈钢.对药物的安全性采取行动的时候到了.美国医学会杂志中文版;1998,17(6):328
    [34]颜敏,吴哗,王兰明,等.药品上市后再评价工作的现状与思考.中国新药杂志;1999,8(7):433-436
    [35]唐镜波.临床药物评价的意义和方法.中国药房;1996,7(6):244
    [36]张承绪.药品上市后再评价概览.中国医药情报;2002,8(3):17-19
    [37]朱炳富,任国娟,严炎中.上市药品的再评价.海峡药学;2006,18(2):203-205
    [38]杨金玉,刘晓峰.药物不良反应294例分析.西北药学杂志;2002,17(5):239-240
    [39]崔昕.一些用了几千年的中药不一定就安全—政协委员建议对朱砂、雄黄的药用价值和安全性进行再评价.中国药业;2007,16(10):18
    [40]孙忠实,朱珠.必须关注药品上市后的再评价.中国医药导报2000;2(1):49-50
    [41]杨耀芳.自发呈报法监测中药的不良反应.40-42
    [42]张力,杨晓晖,曹立亚,等.关于我国中药不良反应监测工作现状和发展的思考.中国中西医结合杂志;2005,25(7):581-584
    [43]张力,杨晓晖,张世臣.中药不良反应发生的原因及其相关对策.中国医药学报;2004,19(8):496-498
    [44]刘滔滔,陈龙英,杨玉芳.542例药品不良反应报表分析.药物与临床;2006,28(8):1292 -1294
    [45]郭晓听,颜敏,王兰明.对妊娠期用药的评价.中国医院药学杂志;2002,22(3):164-165
    [46]徐小薇,王跃明,李大魁.儿科合理用药探索.中国临床药学杂志;2001,10(2):125
    [47]梁颖文,吴季俭.新药在儿科的使用管理与再评价.儿科药学杂志;2004,10(5):29-31
    [48]杨田.ADR监测,战略性前移.中国处方药;2007,10(67):48
    [49]郭晓听,颜敏,张素敏,对药品上市后安全性再评价若干问题的探讨.中国药学杂志;2001年,36(3):205-209
    [50]陈如泉,中药的不良反应与上市后再评价,湖北中医学院学院学报.2003,5(1):5-8
    [51]砂原茂,临床药理学.第1版.重庆:科技文献出版社重庆分社,1982;9
    [52]武凤华,我国药品上市后的再评价,现代医药卫生,2008,24(5):2356-2357
    [53]郭晓听,颜敏,吴哗,等.如何认识中药上市后的再评价,中国新药杂志,2000,9(8):513-515
    [54]孙忠实,朱珠.必须关注药品上市后的再评价,中国医药导报,2000,2(1):49-50.
    [55]宋金波,曹秀琴,耿桂萍,对我国药品再评价制度的认识与探讨,药物警戒,2008,5(2):93-100
    [56]钟素艳,代圆圆,杨剑生.完善我国药品上市后再评价体系.中国卫生事业管理,2004,2:125-126.
    [57]刘惠军.中国药房1991;2(5):22
    [58]孙淑娟.探讨我国临床药师的现状与未来,中国药房,2007,18(1):1
    [59]高尔鑫,陈茹琴.不同程度脾虚患者甲状睐功能改变的临床研究.安徽中医学院学报,1998,17(3):10
    [60]俞亚静.儿童临床用药的注意事项.首都医药,1997,9(6):62
    [61]陈剑鸿,王碧江,刘松青,我国临床药师在用药决策中的地位和作用,中国药师,2001,4(5):347-348
    [62]提高临床药学服务意识,保障安全用药,中国处方药,2007,11(68):6
    [63]倪汀洪.达美康与优降糖治疗糖尿病对比研究.中国医院药学杂志,1989.9(9):393
    [64]施毅等.罗塞秦治疗细菌性感染的临床观察.金陵医院学报,1996.3:208
    [65]唐镜波.临床药物评价的意义与方法.中国药房,1996,7(6):243
    [66]陈巧云,等.我院住院病人抗菌药物应用的调查分析.中国药科大学学报,1996,27:1
    [67]刘侠.边际分析在医院药品经营管理中的应用.首届全国中医药基拙理论与临床学术交流会宣读论文(北京中医药大学学报汇编资料),1996:1029
    [68]黄林清.等.中国药房.1995,6(4):30
    [69]Keith Mr. Am J Hasp Pharm 1989; 46(9):1809
    [70]靳桂明,医院开展药物不良反应监察的一种有效模式,中国药房1993,4(4):22
    [71]闫炜,正确认识中药不良反应推进中药现代化,临床药物治疗杂志,2006,4(6):51-53
    [72]陈如泉,中药的不良反应与上市后再评价,湖北中医学院学院学报,2003,5(1):5-8
    [73]杨金玉,刘晓峰,药物不良反应294例分析,西北药学杂志,2002,17(5):239-240
    [74]杨耀芳,自发呈报法监测中药的不良反应,40-42
    [75]刘滔滔,陈龙英,杨玉芳,542例药品不良反应报表分析,药物与临床,2006,28(8):1292-1294
    [76]张力,杨晓晖,曹立亚,等.关于我国中药不良反应监测工作现状和发展的思考,中国中西医结合杂志,2005,25(7):581-584
    [77]张力,杨晓晖,张世臣.中药不良反应发生的原因及其相关对策,中国医药学报,2004,19(8):496-498
    [78]王晓瑜,杜文民,王宏敏,药品不良反应报告中存在的问题及改进建议,上海医药,2006,27(5):215-217
    [79]中国药业编辑部,我国药品小良反应报告大幅增加但差距仍很大,中国药业,2005,14(9):80
    [80]刘宝洪,杨水新.205例药品不良反应报告综合评价,中国新药杂志,2005.14(8):1076-1079.
    [81]郭晓昕,武志昂,张承绪,美国食品药品监督竹理局对上市药品的特殊风险管理措施,中国医药导刊,2006,8(4):301-302
    [82]吴桦,程鲁榕,郭晓听,美国强化药品风险管理对我国药品再评价工作的启示,药物警戒,2006,3(1):21-25
    [83]宋华妮,李汝霖,毛宗福,关于我国药品上市后再评价制度的探讨,中国新药杂志,2005,14(3):259-262
    [84]钟素艳,代圆圆,杨剑生.完善我国药品上市后再评价体系,中国卫生事业管理,2004,20(2):125-126
    [85]魏水易,药品上市后的再审查和再评价制度,1999,8(4):193-194
    [86]宋金波,曹秀琴,耿桂萍,对我国药品再评价制度的认识与探讨,药物警戒,2008,5(2):93-100
    [87]李少兰,王兰明,颜敏,关于在我国建立药品上市后再评价制度的探讨,中国新药杂志,2001,10(4):241-244
    [88]周元瑶.药物流行病学[M].北京:中国医药科技出版社,1996:1
    [89]武凤华.我国药品上市后的再评价.现代医药卫生;2008,24(5):2356-2357
    [90]李俊,徐叔云.我国临床药理学研究现状.安徽医药;1999,3(4):1-6
    [91]任经天,吴哗,颜敏.双黄连注射剂不良反应回顾性研究.药物流行病学杂志;2004,13(4):188-191
    [92]刘力生,工文.大样本多中心心血管病临床试验的设计与临床意义.中国高血压杂志1994;2:73-74
    [93]王文,刘力生,吴爱丽,等.国际大样本多中心多中心临床试验.中国医药导刊;2000;2:26-27
    [94]孙忠实,朱珠.必须关注药品上市后的再评价.中国医药导报;2000,2(1):49-50
    [95]李廷谦,下刚,王蕾,循证医学与中药上市后的再评价.151-154
    [96]伍沪生.重视药品上市后的安全性再评价.中华风湿病学杂志;2004,8(12):705-706
    [97]李燕,徐进,许静.循证医学在临床药学中的应用.儿科药学杂志;2004,10(5):7-8
    [98]胡大一,杨进刚.应重视上市后药物安全性的循证医学再评价-罗非昔布召回的意义.中国循证医学杂志;2005,5(2):95
    [99]郭晓听.循证医学与药品上市后的再评价.中国新药杂志;2001,10(9):643-645
    [100]刘力生,陶寿淇.我国大样本心血管药物临床试验的回顾与展望.中华心血管病杂志;2000,28:335-338
    [101]梅丹,李大魁.上市药品的质量评价.中国药房;2000,11(6):244-245
    [102]李青,颜敏,吴哗.中华流行病学杂;2004,25(5):435-438
    [103]王忠,下永炎.中药上市后临床再评价研究.中国中药杂志;2007,32(1):84-86
    [104]李廷谦,王刚,王蕾.循证医学与中药上市后的再评价.中国循证医学杂志;2004,4(4):217-221
    [105]商洪才,张伯礼,李幼平.上市后中成药再评价临床定位的原则和方法—基于循证医学的理念.中西医结合学报;2008,6(9):887-890
    [106]王新志,李燕梅.中成药上市后再评价的现状与思考.中国新药杂志;2006,15(18):1517-1519
    [107]周永良,陈红梅,陆红.清开灵注射剂不良反应文献系统评价.中国药业;2007,16(24):50-52
    [108]郭振刚.清开灵治疗流行性出血热72例.中医药;1996,56(4):22
    [109]周正森.清开灵治疗流行性乙型脑炎30例疗效观察.甘肃科技;2001,17(4):48
    [110]邢志平.清开灵注封液治疗单纯疙疹性角膜炎临床观察.中国中医眼科杂志;1995,5(3):156
    [111]武西芳.清开灵注射液治疗病毒性乙型肝炎疗效观察.河南中医;2005,25(3):93
    [112]邓冲.清开灵注射液治疗高血压脑出血术后高热、昏迷的疗效观察.国际医药卫生导报;2005,11(1):93
    [113]于立芬.数理统计方法[M].上海:上海科学技术出版社,1986:127
    [114]下忠,下永炎.中药上市后临床再评价研究.中国中药杂志;2007,32(1):84-86
    [115]陈可冀,宋军.循证医学的提出对中西医结合的启发.中国中西医结合杂志;1999,19(11): 643-644
    [116]谢红娟,杜文民,沈炜明.药物流行病学数据库现状与前景展望.医药导报;2007,26(2):217
    [117]严明,邢花.借鉴美国CDER经验完善我国药品再评价体系.国际医药卫生导报;85-87
    [118]王新志,李燕梅.中成药上市后再评价的现状与思考.中国新药杂志;2006,15(18):1517-1519
    [119]The European Agency for the Evaluation of Medicinal Products Human Medicines Evaluation Unit. ICH Topic E9-Statistical Principles for Clinical Trials[R]. London,1998; 18
    [120]Lange S, Freitag G, Trampisch HJ. Practical experience with the design and analysis of a three-armed equivalence study[J]. Eur J Clin Pharmacol,1998; 54:535-40
    [121]刘玉秀,姚晨.非劣效性/等效性实验中的统计学分析.中国临床药理学杂志;2000,16(6):448-452.
    [122]梁平,李彬,邹江峰.阿奇霉素对照苄星青霉素阻断梅毒母婴垂直传播的非劣效性研究.岭南皮肤性病科杂志;2006,13(5):367-369
    [123]The Amadeus Investigators. Comparison of idraparinux with vitaminK antiagonists for prevention of thromboembolism in patients with a trial if brillation:a randomised, open —label, non—nferiority trial, The World Clinical Medicine,2008,2(8):647—653
    [124]蒋萌,熊宁宁,严道南.植物药仙露贝滴剂治疗急性鼻窦炎的非劣效性临床研究.中国临床药理学与治疗学;2003,8(3):286-288
    [125]吕静静,于浩,陈峰.率的等效性检验方法的比较.中国临床药理学与治疗学;2004,9(3):354-357
    [126]侯艳,武振宇,李康.临床新药试验中非劣效性检验界值的确定方法.中国卫生统计2008;25(6):648-651
    [127]于莉莉,夏结来,蒋红卫.几种简单设计的等效性检验的样本量与检验效能.第四军医大学学报;2004,25(11):1045-1049
    [128]刘玉秀,姚晨,陈峰.临床非劣效性/等效性评价的统计学方法.中国临床药理学与治疗学;2000;5(4):344-348
    [129]工思道.等效性检验在临床药效研究上的应用.安徽医科大学学报;1990,25(4):258-259
    [130]ICHE9, Statistical Principles for Clinical trials,1998
    [131]苏炳华,主编.新药临床试验,统计分析新进展[M].第1版.上海:上海科学技术文献出版
    社,2000:46-62
    [132]刘玉秀,姚晨,陈峰.非劣效性/等效性试验中的统计学分析.中国临床药理学杂志;2000,16(6):448-452
    [133]工杨,李卫,成小如.随机模拟法验证非劣效临床试验样本量计算公式.中国卫生统计;2008,25(1):26-27
    [134]于莉莉,夏结来,陈启光.显著性检验与等效性检验的区别与联系.中国卫生统计;2005,22(1):37-38
    [135]刘玉秀,杨友春.临床实验疗效的等效性评价.中国临床药理学与治疗学杂志:1999,4:220-223
    [136]张高魁,夏结来,姚晨.相对率的非劣效性试验检验效能及样本量的模拟计算方法及SAS实现.中国临床药理学与治疗学;2004;9(2):234-23
    [137]孙志民,孙瑞元.临床研究中等效性分析一等效界值法.中国临床药理学杂志;1995 11(2):116-118
    [138]刘玉秀,姚晨,陈峰.临床非劣效性/等效性评价的统计学方法.中国临床药理学与治疗学;2000;5(4):344-348
    [139]Garbe E, Rohmel J, Gundert-RemyU,et al. Clinical and statistical issues in therapeutic equivalence trials. Eur J Clin Pharmacol,1993;45:1-7
    [140]Redmond CK, Colton T. Biostatistics in Clinical Trials. Chichester:John Wiley & Sons Ltd, 2001:179-183,403-405
    [141]左晓春.临床试验中采用非劣效设计应该关注的问题.中国新药杂志;2007,16(9):662-664
    [142]闫宇翔,王洪源,王仁安.多临床终点的等效性检验方法探讨.中华流行病学杂志;2003,24(10):935-938
    [143]闫宇翔,王洪源,王仁安.新药临床等效性分析方法及其评价.中国临床药理学与治疗学;2003,8(2):219-222
    [144]张海宁,张晋昕,薛允莲.正确运用统计学检验方法判定两治疗方案疗效等价.循证医学;2008,8(4):228-230
    [145]Mellenhergh, GJ. Measurement precision in test and score item response models.Psychological Methods.1996.3:293-299
    [146]工爱英,施学忠,杨永利.等效性检验若干问题分析.郑州大学学报(医学版);2008,43(5):990-992
    [147]朱泉,梁伟雄.等效性临床试验等效界值确定原则的探讨.中国临床药理学与治疗学;2005,10(8):957-960
    [148]刘玉秀,姚晨,陈峰.非劣效/等效性试验的样本含量估计及把握度分析.中国医药卫生统计;2004,21(1):31-35
    [149]Krysan DJ, Kemper AR. Claims of equivalence in randomized controlled trials of the treatment of bacterial meningitis in chil-dren. Pediatr Infect Dis J,2002; 21 (7):753-758
    [150]朱泉,梁伟雄.等效性临床试验等效界值确定原则的探讨.中国临床药理学与治疗 学;2005,10(8):957-960
    [151]安胜利,陈平雁.等效性检验与差异性检验的区别及其模拟验证.中国卫生统计;2007,24(3):226-228
    [152]Equiv Test TM Software for the Statistical Analysis of Equivalence and Bioavailability Studies.Statistical Solutions Ltd,2001.
    [153]曹胜炎,肖应艺.两个率比较实验中的最佳样本容量.数理医药学杂志;1994,7(3):241-243
    [154]郑青山,孙瑞元,陈志扬.新药临床非劣性及等效性试验中的例数估计和等效标准.中国新药杂志;2003,12(5):368-370
    [155]闫宇翔,下洪源,王仁安.等效性评价方法研究现状.药物流行病学杂志;2003,12(5):253-256
    [156]左晓春.临床试验中采用非劣效设计应该关注的问题.中国新药杂志;2007,16(9):662-664
    [157]刘玉秀,姚晨,陈峰,等.非劣效性/等效性试验中的统计学分析.中国临床药理学杂志;2000,11(16):448-452
    [158]Gould AL. Another view of active-controlled trials. Control Clin Trials,1991,12(4):474-485
    [159]朱泉,梁伟雄.等效性临床试验等效界值确定原则的探讨.中国临床药理学与治疗学;2005,10(8):957-960
    [160]倪宗瓒,主编.医学统计学.第二版·北京:人民卫生出版社,1998:21,44
    [161]ChowSC, Shao J. An alternative approach for the assessment of bioequivalence between two formulations of a drug[J]. Biomet-rical J,1990;32:969-76
    [162]International Joint Efficacy Comparison of Thrombolytics. Ran—omised, double-blind comparison of reteplase double-bolus ad-ministration with streptokinase in acute myocardial infarction (INJECT):trial to investigate equivalence. Lancet,1995; 346: 329-336
    [163]International Conference on Harmonization Guidance on choice of control group and related design and conduct issues in clinical trials(ICHE10). Food and Drug Administration, DHHS,2000
    [164]HungH, Wang SJ, Tosng Y. et, al. Some fundamental issues with non-inferiority testing in active controiled cliniclatrilas. Stat Med,2003,22:212-225
    [165]HungHMJ, W angSJ。 O'NeilRT. A regulatory Perspective on Choice of Margin and Statisticla Inference Issue in Non—in ferioirty Trials. Bio—etircal J,2005,47:28— 36
    [166]LangeS. Freitag G. Special Invited PapersSection:Therapeutic Equivalence—Clinical Issues and Statistical Methodology in NoninferiorityTrilas. Biometircla,2005,47:12 —27
    [167]柳再华,陈汇,刘建华.等效性研究的常用统计分析方法及其评价.数理医药学杂志;2003,16(5):391-394
    [168]Mattsson LA, Christiansen C, Colau JC, Palacios S, Kenemans P, Bergeron C,et al. Clinical equivalence of intranasal and oral 17beta-estradiol for postmenopausal symptoms[J].Am JObstet Gynecol,2000;182:545-52
    [169]Simon R. Bayesian design and anlaysis of active control clinical trials. Biometrics,1999, 55:484-487
    [170]HolmgrenEB Establishing equivalence by showing that a prespecifided percentage of the effect of the active control over placebo is maintained. JBiopharStato 1999,9(4):651 —659
    [171]WangSJ, Hung HMJ, Tsong Y. Utilityna dpitfall of some statisticiam ethodsin active contro Ued cilnicaltrilas. Control Clin Trials,2002,23:15—28
    [172]HasselbladV, KongDF. Statistical methods for comparison to placebo in active-controltrials. Drug lnfJ。 2001。 35:435—449
    [173]WangSJ, HungHMJ. Assessment of treatment efficacy in the non-inferiority trilas. ControlClinTrilas,2003,24:147-155;
    [174]RothmannM, LiN, ChenG, etal. Non-inferiority methods for mortality trials. StatMed, 2003,22:239-264
    [175]HungH, Wang SJ, Tosng Y. et, al. Some fundamentla issues with non-inferiority testing in active controiled clinicla trilas. Stat Med,2003,22:212-225
    [176]HungHMJ, W angSJ-O'NeilRT. A regulatory Perspective on Choice of Margin and Statisticla Inference Issue in Non—n ferioirty Trials. Bio—etircal J,2005,47:28— 36
    [177]Simon R. Bayesian design and anlaysis of active control clinical trials. Biometrics,1999, 55:484-487
    [178]Rothmann M, LiN, ChenG, etla. Non-inferiority methods for mortlaity trilas. Prcoeedings of the Biopharmaceutieal Section of the American Statisticla Association,2001
    [179]HungH, Wang SJ, TosngY. et, al. Some fundamentla issues with non-inferiority testing in active controiled clinicla trilas. Stat Med,2003,22:212-225
    [180]HungHMJ, W angSJ。 O'NeilRT. A regulatory Perspective on Choice of Margin and Statisticla Inference Issue in Non—in ferioirty Trials. Bio—etircal J,2005,47:28— 36
    [181]WangSJ, Hung HMJ, Tsong Y. Utilityna dpitfall of some statisticlam ethodsin active contro Ued cilnicaltrilas. Control Clin Trials,2002,23:15—28
    [182]HasseIbladV, KongDF. Statistical methods for comparison to placebo in active-controltrials. Drug lnfJ。 2001.35:435—449
    [183]International Conference on Harmonisation. Guidance E10:Choice of control group and related issues in clinical trials [J/OL]. Http://www. emea. europa. eu/pdfs/human/ich/036496en. pdf 2000-07-01
    [184]黄饮,赵明.对临床试验统计学假设检验中非劣效、等效和优效性设计的认识.中国临床药理学杂志;2007,23(1):63-67
    [185]刘玉秀,姚晨,陈峰,等.非劣效性/等效性试验中的统计学分析.中国临床药理学杂志;2000;16:448-452
    [186]EMEA CPMP:Guideline on the choice of the non-inferiority margin.http://www.emea.europaeu/pdfs/human/ewp/215899en. pd,2005-07-01
    [187]孙志民,孙瑞元.临床研究中等效性分析一等效界值法.中国临床药理学杂志;1995 11(2):116-118
    [188]International Conference on Harmonization Guidance on choice of control group and related design and conduct issues in clinical trials(ICHE10). Food and Drug Administration, DHHS,2000
    [189]CPMP. Guideline on the choice of the non—nferority margin.2005 EMEC,2158/99
    [190]黄钦,赵明.对临床试验统计学假设检验中非劣效、等效和优效性设计的认识.中国临床药理学杂志;2007,23(1):63-67
    [191]Blackwelder WC. Proving the nuu hypothesis in clinical trials. Control Clin Trials,1982, 3:345.353
    [192]Tosng Y, Higgins K, Wangs ST,et al. An overview of equivlaence testing-CDER reviewers perspective. Proceedings of the Biopharmaeeuticla Section of American Statistical Association,1999,214—219
    [193]侯艳,武振宇,李康.临床新药试验中非劣效性检验界值的确定方法.中国卫生统计;2008:25(6):648-651
    [194]Chow SC, ShaoJ. Noinferiority margin and statistical tests. StatMed,2006,25:1101-1113
    [195]HungH, Wang SJ, TosngY. et, al. Some fundamentla issues with non-inferiority testing in active controiled clinicla trilas. Stat Med,2003,22:212-225
    [196]Chow SC, ShaoJ. Noinferiority margin and statistical tests. Stat Med,2006,25: 1101.11-13:Chow SC, ShaoJ. Onnon. infeiroirty margin and statistical tests in active control trials. StatMed,2006,25:1101—1113
    [197]Tosu HH, Hsiao CF,, ChowSC。Et,al. Mixed Noninferiority Margin and Statisticla Tests in Active of controled Tirals. J BiopharStat,2007,17:339—357
    [198]郑青山,孙瑞元,陈志扬.临床两组药物等效的判断方法及其辨析.中国临床药理学与治疗学;2002;7(6):559-561
    [199]刘玉秀,姚晨,陈峰.临床试验配对二项数据基于率比的非劣效性/等效性评价.中国卫生统计:2008,25(3):317-319
    [200]闫宁翔,工洪源,孙尚拱,以量表评分作为临床终点的等效界值确定方法,数理医药学杂志,2003,16(2):99-101
    [201]闫宇翔,王洪源,王仁安.新药临床等效性分析方法及其评价.中国临床药理学与治疗学;2003,8(2):219-222
    [202]International joint efficacy comparison of thrombolytics. Ran-domized, double blind comparison of reteplase double-bolus ad-ministration with streptokinase in acute myocardial infarction (inject):trial to investigate equivalence [J]. Lancet,1995; 346:329-36
    [203]姚晨,陈峰,张高魁.交叉试验设计资料的等效性检验.中国临床药理学杂志;2001,17(4):294-270
    [1]闫炜.正确认识中药不良反应推进中药现代化.临床药物治疗杂志;2006,4(6):51-53
    [2]陈如泉.中药的不良反应与上市后再评价.湖北中医学院学院学报;2003,5(1):5-8
    [3]Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug re-actions in hospitalized patients:a meta—analysis of prospective stud-ies. JAMA,1998,279(15):1200—1205
    [4]Friedmen MA, Woodcock J, Lumpkin MM, et al. The safety of newly approved medicines. JAMA,1999,281 (18):1728 — 1734
    [5]黄林清,徐长福.开展药物不良反应监察史之我见.中国药房;1995,6(4):30
    [6]耿洪业,编.实用治疗药物学.人民卫生出版社;1998.17
    [7]张宪安.实用药源病学.中国医药科技出版社;1997.5
    [8]杨金玉,刘晓峰.药物不良反应294例分析.西北药学杂志;2002,17(5):239-240
    [9]杨耀芳.自发呈报法监测中药的不良反应.40-42
    [10]刘滔滔,陈龙英,杨玉芳.542例药品不良反应报表分析.药物与临床;2006,28(8):1292-1294
    [11]张力,杨晓晖,曹立亚,等.关于我国中药不良反应监测工作现状和发展的思考.中国中西医结合杂志;2005,25(7):581-584
    [12]张力,杨晓晖,张世臣.中药不良反应发生的原因及其相关对策.中国医药学报;2004,19(8):496-498
    [13]王晓瑜,杜文民,王宏敏.药品不良反应报告中存在的问题及改进建议.上海医药;2006,27(5):215-217
    [14]中国药业编辑部.我国药品小良反应报告大幅增加但差距仍很大.中国药业,2005,14(9):80
    [15]刘宝洪,杨水新.205例药品不良反应报告综合评价.中国新药杂志;2005.14(8):1076-1079
    [16]曹立亚,张承绪,郭晓听,等.关于我国药品上市后评价技术工作的思考.中国药物警戒;2006,3(1):1-5
    [17]杜广清.药品不良反应评价体系相关问题及对策初探.中国药事;2007,21(1):31-32
    [18]陈永法,刘平羽,张成绪.建立与完善我国药品再评价体系的研究.西北药学杂志;2005,20(3):131-134
    [19]于星.药品生产经营企业是报告药品不良反应的主体.10-13
    [20]刘平羽.国外药品上市后再评价制度简介.上海医药;2004,25(5):208-210
    [21]魏水易.药品上市后的再审查和再评价制度.药物流行病学杂志;1999,8(4):193-196

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