新诊断免疫性血小板减少症中医临床路径的应用研究

Research on TCM Clinical Pathway for Newly Diagnosed Immune Thrombocytopenia

目的：评价新诊断免疫性血小板减少症（ITP）中医临床路径在临床的应用效果。方法：收集成都中医药大学附属医院儿科病房2012年1月~2014年12月期间住院并诊断为新诊断免疫性血小板减少症患儿资料,根据是否实施临床路径分为临床路径组（23例,年龄1~18岁）与对照组（20例,年龄1~18岁）,分别评价2组住院总费用、住院天数及中医证候疗效。结果：路径组平均住院总费用为（3030.16±412.35）元,明显低于非路径组的（3543.24±502.25）元,2组比较差异有统计学意义（P〈0.01）。路径组患儿平均住院天数为（10.45±2.38）d,非路径组为（12.11±2.88）d,2组比较差异有统计学意义（P〈0.05）。路径组患儿治疗后总有效率为95.66%,非路径组患儿治疗后总有效率为90%,两者差异无统计学意义（P〉0.05）,但路径组总有效率高于非路径组。结论：新诊断免疫性血小板减少症中医临床路径可减少平均住院总费用,减少平均住院天数,提高中医证候疗效。

Objective： To evaluate the effieaey of TCM clinical pathway for newly diagnosed immune thremboeytopenia （ITP）. Methods： Data were collected from children hospitalizated with newly diagnosed immune thromboeytopenia in the pediatric ward in Teaching Hospital of Chengdu University of T. C. M from January 2012 to December 2014. According to implement ofthe clinical path- way management, all patients were divided into pathway group （ n = 23 ）, and non-pathway group （ n = 20） . Hospitalization costs, average hospital stays and the relief of TCM symptom scores were assessed in both groups. Results： The hospitalization costs in the pathway group and non-pathway group were （3030. 16 ±412. 35） yuan and （3543.24 ±502. 25） yuan respectively, with a significant difference between both groups （ P 〈 0. 01 ） . The average hospital stays in the pathway group and non-pathway group were （ 10. 45 ± 2. 38） days and （12. 11 ± 2. 88） days respectively, with a significant difference between groups （P 〈 0.05） . The TCM symptom scores were significantly decreased after treatment in both groups. The total effective rate of the pathway group was 95.66%, while the non-pathway group was 90%, with no significant difference between groups （ P 〉 0. 05 ） . Conclusion： The TCM clinical pathway for Newly Diagnosed Immune Thremboeytopenia （ITP） can effectively reduce the hospitalization costs, the average hospital stays and re- lief TCM symptoms.