不同药物方案治疗慢性阻塞性肺疾病的成本-效果分析

Comparison of drug economics of different drug treatment schemes COPD

目的探讨不同药物方案沙美特罗替卡松粉吸入剂以及布地奈德联合硫酸特布他林治疗慢性阻塞性肺疾病(COPD)的成本-效果。方法选取2014年1月至2016年1月于梅州市中医医院就诊的50例COPD患者作为研究对象,采用随机数法表法将其分为A组和B组,各25例。A组患者使用沙美特罗替卡松粉吸入剂治疗,B组患者采用布地奈德联合硫酸特布他林进行治疗。比较两组患者临床治疗效果、肺功能相关指标及成本-效果,并进行敏感性分析。结果 A组患者治疗的总有效率明显高于B组,差异有统计学意义(P<0.05);治疗后,A组患者的第1秒用力呼气量(FEV1)/用力肺活量(FVC)和第1秒用力呼气量占预计值百分比(FEV1%)均明显高于B组,差异均有统计学意义(均P<0.05);两组患者成本-效果比显示,A组明显低于B组,差异有统计学意义(P<0.05);假设本研究药物价格下降10%,其他治疗费用不变,A组成本-效果比仍明显低于B组,差异有统计学意义(P<0.05)。结论沙美特罗替卡松粉吸入剂在治疗COPD,明显优于布地奈德联合硫酸特布他林的治疗效果,能够有效提高患者的肺功能,且具有较佳成本-效果比以及较高的临床应用价值。

Objective To explore Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation and terbutaline sulfate combined with budesonide in the treatment of chronic obstructive pulmonary disease （COPD） cost effectiveness.Methods 50 patients with COPD who were treated in Meizhou Hospital of traditional Chinese medicine from January 2014 to January 2016 were selected and divided into A group and B group by random number table method,each with a total of 25 cases.A group of patients using Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation treatment,B group were treated with budesonide combined with terbutaline treatment.Two groups of patients with clinical treatment,lung function related indicators and cost-effectiveness,and sensitivity analysis.Results The treatment of A patients with total efficiency was significantly higher than that of B group,the difference was statistically significant（P〈0.05）;after the treatment,the forced expiratory volume in one second in group A （FEV1）（FVC）/FVC and FEV1 percent predicted （FEV1%） were significantly higher than B group,difference there was statistically significant（P〈0.05）;the ratio of cost and effect of the two groups,A group was significantly lower than B group,the difference was statistically significant（P〈0.05）;the research hypothesis 10% decline in prices of drugs,other treatment costs unchanged,A group cost-effectiveness ratio is significantly lower than B group,the difference was statistically significant（P〈0.05）.Conclusion Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation in the treatment of COPD was better than that of budesonide combined with terbutaline treatment effect,can effectively improve the pulmonary function of patients,and has better costeffect ratio and higher value of clinical application.