过敏性鼻炎-哮喘综合征的临床经济学研究

Clinical economy investigation on combined allergic rhinitis and asthma syndrome

目的明确过敏性鼻炎-哮喘综合征(combined allergic rhinitis and asthma syndrome,CARAS)这一新的医学诊断术语。从临床经济学角度出发,对经鼻吸入糖皮质激素对CARAS联合治疗与传统的采用鼻喷雾剂和口喷雾剂分别治疗的成本/效果比(C/E)进行研究比较。方法哮喘门诊中随机选择CARAS患者74例,随机分为两组。其中一组为联合治疗组,采用经鼻吸入糖皮质激素喷雾剂进行治疗;另一组为传统治疗组,采用鼻喷雾剂和口喷雾剂分别进行治疗,疗程3个月。分别计算两组治疗的总费用(C),治疗后鼻部症状改善总评分(E1)、胸部症状改善总评分(E2)和PEFR增加值(E3),分别计算联合治疗组和传统治疗组的C/E1,C/E2和C/E3。结果C/E1,联合组为8.194,传统组为17.499;C/E2,联合组为9.001,传统组为15.432;C/E3,联合组为8.489,传统组为15.867。结论联合治疗组和传统治疗组在临床疗效基本相同的情况下,联合治疗组3个指标的C/E都远远低于传统治疗组的C/E,联合治疗这一新的治疗方式更具有临床经济学意义。

Objective To define the new medical diagnostic term,which combines allergic rhinitis and asthma syndrome（CARAS）. The cost/effectiveness ratio （C/E） value is interpreted and compared from clinical economy perspective on two different administrations in term of combined intranasal corticosteroids and traditional inhale corticosteroids （ICS） nasal and oral separately for treating CARAS. Methods 74 CARAS cases were selected from asthma clinic, then divided into two groups randomly, one group treated with combined ICS by nasal, another with traditional ICS by nasal and oral inhalation separately, the therapeutic course was 3 months. The total cost of two groups was calculated respectively, the result was （C）,the nasal symptom total improved scores was （El） and the chest symptom total improved scores was （E2） ,PEFR improvement was （E3）. The combined treatment group and traditional group C/E as C/E1, C/E2 and C/E3 were figured out. Results The nasal symptom improvement C/E was C/E1,the combined group was 8. 194,the traditional group was 17. 499,the chest symptom improvement C/E was C/E2,the combined group was 9. 001, the traditional group was 15. 432, PEFR improvement C/E was C/E3 the combined group was 8. 489, the traditional group was 15. 867. Conclusions Almost same clinical outcomes are achieved by combined treatment group and traditional group, but three indicators of C/E of combined group are much more lower than those of traditional group, which demonstrates that the new approach of combined treatment is meaningful for clinical economy.