依据证候要素辨证治疗慢性心衰的成本——效用分析  

Cost-efficacy Analysis of Syndrome Differentiation and Treatment for Chronic Heart Failure Based on Syndrome Elements

作　　者：李彬[1] 陈静[2] 赵慧辉[2] 王居新 李婷 王娟[2] 王伟[2] 

机构地区：[1]北京中医药大学第一临床医学院东直门医院,北京100700 [2]北京中医药大学 [3]北京昌平区中医医院

出　　处：《西部中医药》2015年第9期56-59,共4页Western Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研专项项目(编号200807007)

摘　　要：目的:比较2种方案改善慢性心衰的生存质量及其费用的成本-效用比值,探讨依据证候要素辨证治疗慢性心衰的可行性。方法:将慢性心衰患者99例随机分为试验组和治疗组,治疗组接受西医常规治疗,试验组在此基础上依据证候要素组合予中药辨证治疗,计算患者28天心衰治疗中发生的直接医疗成本,观察慢性心衰中西医结合生存质量量表评分及质量调整生命(QALY),并进行成本-效用分析。结果:试验组患者的心衰量表评分及QALY分别为(76.91±19.94)分和(0.064±0.017),对照组分别为(71.39±21.26)分和(0.059±0.018),组内治疗均较前有明显改善(P<0.05),组间比较差异无统计学意义(P>0.05);试验组每获得一个QALY的成本为558269.17元低于对照组1159066.25元。结论:依据证候要素辨证治疗慢性心衰可以改善生存质量,节省医疗资源,属较优方案。To explore the feasibility of syndrome differentiation and treatment for chronic heart disease （CHD） based on syndrome elements by comparing cost-efficacy values of two therapies in improving quality of life and the cost of CHD patients. Methods： Ninety-nine CHD patients were randomized into the experiment group and the treatment group, the treatment group accepted routine treatment of western medicine, and the experiment group syndrome differentiation and treatment according to syndrome elements, to calculate direct medical cost of treating CHD in 28 days, to observe CHD patients quality of life scaling treated by integrative medicine and quality adjusted life year （QALY）, and perform cost-efficacy analysis. Results： The scales of heart failure scaling and QALY in the experiment group were （76.91 ±19.94） and （0.064±0.017） respectively, while these of the control group were （71.39± 21.26） and （0.059±0.018） scales, there were notable improvements after treating compared with before treating（P〈0.05）, and there was no statistical meaning between groups （P〉0.05）; The experiment group（558269.17 RMB） was lower than the con- trol group in QALY cost （1159066.25 RMB）. Conclusion： Syndrome differentiation and treatment for CHD based on syndrome elements could improve quality of life and save medical resources, which are of better plan.

关 键 词：慢性心衰 生存质量 成本-效用分析 质量调整生命年 证候要素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]