非小细胞肺癌住院病例的成本-效果回顾性研究

目的评价中医药对提高中晚期非小细胞肺癌临床疗效的价值。方法从药物经济学角度回顾性研究，选择符合纳入标准的住院患者，按治疗方案分为中医组、中西医结合组、西医组，以瘤体变化、生存质量、主要症状3项加权评分作为衡量疗效的效果指标，对3种治疗方案进行成本-效果分析。结果共纳入合格病例233例。中医组56例，中西医组77例，西医组100例。中医组总有效率为73.21％，稳定率为96.43％；完成疗程人均费用12663.94元；总有效率、稳定率每增加1个百分点成本分别为173.00元，131.64元。中西医结合组总有效率为80.52％，稳定率为98.70％；完成疗程人均费用22924.05元；总有效率、稳定率每增加1个百分点成本分别为284.77元，232.26元。西医组总有效率为54.00％，稳定率为89.00％；完成疗程人均费用30077.80元；总有效率、稳定率每增加1个百分点成本分别为557.00元，337.95元。结论中医药治疗是中晚期非小细胞肺癌的一种经济、有效的治疗方案。

Cost-Effectiveness Retrospective Study of Non-Small Cell Lung Cancer Cases

Objective To discuss the value of using TCM to improve the clinical effects in intermediate and advanced stage non-small cell lung cancer. Methods To adopt the retrospective study from the pharmaceutical economics angle and to choose the inpatients according with the inclusion criteria,dividing them into TCM group,integrated traditional Chinese and western medicine group,western medicine group by treatment protocols. To analyze the cost-effects of the three treatment protocols by using the three-term weighted mark of tumor body change, quality of life, main symptoms total effective rates as the effect measure indexes. Results Altogether 233 cases were brought into the program,including 56 cases in TCM group,77 cases in integrated traditional Chinese and western medicine group, 100 cases in western medicine group. In TCM group,the obvious effective rate was 73.21% ,the stable rate 96.43% and the mean expense 12 663.94 yuan. To increase one percentage point of the obvious effective rate and the stable rate,cost increased 173.00 yuan and 131.64 yuan respectively. In integrated traditional Chinese and western medicine group,the obvious effective rate was 80.52% ,the stable rate 98.70% and the mean expense 22 924.05 yuan. To increase one percentage point of the obvious effective rate and the stable rate,cost increased 284.77 yuan and 232.26 yuan respectively. In western medicine group,the obvious effective rate was 54. 0% ,the stable rate 89.0% and the mean expense 30077.8 yuan. To increase one percentage point of the obvious effective rate and the stable rate, cost increased 557.00 yuan and 337.95 yuan respectively. Conclusion TCM is an economic and effective treatment protocol to treat intermediate and advanced stage non-small cell lung cancer.