【摘要】 目的探讨我院呼吸科门诊使用舒利迭联合噻托溴铵、信必可联合噻托溴铵和帮备3种方案治疗慢性阻塞性肺疾病(COPD)稳定期的成本-效果,为临床合理用药,合理分配医疗费用提供参考依据。方法采用随机、开放、平行对照试验设计,将符合纳入标准的患者共56例,随机分为3组,分别为A组(舒利迭50μg/500μg 2次/d联合噻托溴铵18ug 1次/d)、B组(信必可都保160μg/4.5μg 2次/d联合噻托溴铵18μg 1次/d)、C组(帮备10mg 1次/d睡前服用),均随访16周,运用药物经济学成本-效果分析方法进行评价,并进行敏感度分析。结果 A组与B组总有效率基本相同,分别为94%和89%(P>0.5),成本-效果比分别为32.18和27.25,C组总有效率为73%,成本效果比为4.43。结论 A、B两组治疗COPD患者效果均较好,但相应成本较高,C组疗效较A、B两组稍差,但成本较低,因此临床医生可以将治疗方案与患者的实际经济状况相结合选择合适的治疗方案。更多还原

【Abstract】 Objective The aim of this trial is to study cost-effectiveness of three kinds of treatments that are Salmeterol/Fluticasone propionate(Seretide)combine Tiotropium Bromide inhalation,Budesonide / Formoterol Fumarate combine Tiotropium Bromide inhalation and Bambec for outpatients with stable chronic obstructive pulmonary disease in respiratory department,and to provide references for rational drug usage in clinic and reasonable distribution of medical expenses.Methods 56 patients who met the inclusion criteria were randomly divided into three groups by a randomized,open and parallel controlled trial.The therapeutic interventions in group A were Seretide plus Tiotropium Bromide in which patients were given Seretide(50μg/500μg)inhaling twice daily and Tiotropium Bromide(18μg)inhaling once daily;Patients in group B were given Budesonide / Formoterol Fumarate(160μg/4.5μg)inhaling twice daily and Tiotropium Bromide(18μg)inhaling once daily,and Patients in group C were given Bambec 10mg quaque nocte.The trial was lasting for 16 weeks,using drug cost-effectiveness analysis and sensitivity analysis methods to evaluate outcomes.Results The total curative effective rate of group A and group B was similar,it was respectively 94% and 89%(P>0.05),and the cost-effect rate was respectively 32.18 and 27.25;The total curative effective rate of group C was 73%,and the cost-effect rate was 4.43.Conclusion Although group A and group B both had higher curative effect than group C,by contrast the corresponding treatment costs is higher.So the doctor should consider not only the therapeutic effect,but also the patient economic conditions.更多还原