活血化瘀类中药注射剂在颈椎病非手术治疗中的药物经济学评价分析

Pharmacoeconomics analysis of the traditional Chinese medicine injections for invigorating blood circulation and eliminating stasis in cervical spondylosis patients with non-surgical treatment

  • 摘要: 目的 评价活血化瘀类中药注射剂在颈椎病非手术治疗中的经济性,为治疗颈椎病提供经济、有效、安全的治疗方案。 方法 采用回顾性研究方法,选择区域内4家综合性医疗机构2015—2017年诊断为颈椎病的住院患者242例为研究对象,按照药物治疗方案的不同分成观察组177例和对照组65例,观察组使用活血化瘀类中药注射剂,对照组不使用活血化瘀类中药注射剂,统计2组临床疗效、不良反应及费用,并采用最小成本法对2组进行分析。 结果 观察组、对照组的治愈率分别为2.8%、4.6%, 好转率分别为97.2%和93.8%, 2组治愈率、好转率及总有效率比较,差异均无统计学意义(P>0.05); 观察组、对照组的人均医疗总成本分别为13 154.4、12 276.2元人民币,观察组患者所需成本高于对照组,敏感度分析结果与最小成本分析结果一致。 结论 对于非手术治疗的颈椎病患者,使用活血化瘀类中药注射剂治疗与不使用此类药物治疗的疗效无显著差异,但使用活血化瘀类中药注射剂治疗的成本较高,不具有经济学优势。现实情况中活血化瘀类中药注射剂在颈椎病治疗中的大量使用现象值得深思,有关部门对此应采取相应的规范措施。

     

    Abstract: Objective To evaluate the economic efficiency of the traditional Chinese medicine injection for invigorating blood circulation and eliminating stasis in cervical spondylosis patients with non-surgical treatment, providing economical, effective and safe treatment options for cervical spine disease. Methods A total of 242 inpatients diagnosed as cervical spondylosis in four comprehensive hospitals in the region between 2015 and 2017 were selected as study subjects by retrospective study method, and were divided into observation group(n=177)and control group(n=65)according to therapeutic schedule. The observation group was given traditional Chinese medicine injection for invigorating blood circulation and eliminating stasis, while the control group was not given the same therapy. Therapeutic efficacy, the occurrence of adverse reactions and cost during treatment of two groups were recorded. Cost-minimization method was given to the two groups for analysis. Results The cure - rates of observation group and control group were 2.8%, 4.6%, respectively; improvement rates were 97.2%, 93.8%, respectively. There were no statistical significant differences in cure rate and improvement rate(P>0.05). The total medical cost per person of two groups were 13 154.4, 12 276.2 Yuan, respectively, and the observation group was higher than control group, and the results of sensitivity analysis were consistent with the results of cost-minimization analysis. Conclusion For non-surgical treatment patients with cervical spondylosis, there is no significant difference in the efficacy of treatment with or without TCM injection for invigorating blood circulation and eliminating stasis, but TCM injection has higher cost, but no economic advantage. Therefore, the phenomenon of the extensive use of TCM injection for invigorating blood circulation and eliminating stasis in the treatment of cervical spondylosis deserves deep consideration. It is hoped that relevant departments will adopt corresponding normative measures in this regard.

     

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