稳心颗粒与倍他乐克治疗室上性早搏的成本效果分析

Wenxin granule and metoprolo for superventricular premature beat: a cost-effectiveness analysis

[目的]比较联用稳心颗粒/倍他乐克和单用倍他乐克治疗室上性早搏的疗效和费用,并进行成本效果分析,为临床工作提供指导和帮助。[方法]将2014年10月—2015年10月期间于本院接受治疗的136例室上性早搏患者纳入研究,按治疗方案分为2组:联合用药组(稳心颗粒联合倍他乐克)和倍他乐克组(单用倍他乐克)。治疗4周后统计两组患者的疗效和费用,采用欧洲五维健康量表(EQ-5D)评价患者生活质量。根据随访结果采用成本效果分析的方法计算两种治疗方案的成本效果比和增量成本效果比。[结果]联合用药组患者治疗有效率和生活质量改善均优于倍他乐克组(P<0.05),两组患者治疗成本分别为326.2元和22.3元,成本效果比分别为388.3和30.1,增量成本效果比为3 039。[结论]联合用药治疗室上性早搏能够明显提高临床疗效。成本效果分析结果提示联合用药虽然效果好但花费也高,从卫生经济学角度并不能完全推荐联合用药,医生应根据患者身体和经济状况合理选择治疗方案。

[Objective] To compare the combination of Wenxin granule and metoprolo and single metoprolo for superventricular premature beat with cost-effectiveness analysis from health economic evaluation perspective. [Methods] The 136 patients with superventricular premature beat were admitted into our study from October 2014 to October 2015 and divided into 2 groups including combination group and metoprolo group according to treatment plan. After 4 weeks treatment we evaluated the clinical effects and quality of life for the patients in the 2 groups. EQ-5D scale was applied for quality of life evaluation. Eventually these data were used for cost effectiveness analysis. [Results] The cilinical outcome of combination group was better than that in single metoprolo group(P<0.05). The total cost of combination group and single metoprolo group was 326.2 yuan and 22.3 yuan respectively. Therefore the cost effectiveness ratio(CER)was 388.3 and 30.1, and the ICER was 3 039 which means the patients in combination group spend more money but also receive better results. [Conclusion] Combination treatment plan can provide better clinical outcome, however the total cost is also higher than single metoprolo treatment. Therefore the combination treatment maybe not the best choice for all the patients, doctors should choose the right plan according to the patients' actual situation.