痰热清注射液静脉滴注联合雾化吸入给药治疗中、重度慢性阻塞性肺病急性加重临床疗效和经济学研究

目的 研究痰热清静脉滴注联合雾化吸入与静脉滴注或雾化吸入给药治疗中、重度慢性阻塞性肺病急性加重(AECOPD)的临床疗效和经济学。方法 将2014年5月—2015年5月就诊的120例AECOPD患者随机分为对照组、静脉滴注组、雾化吸入组和联合给药组。对照组给予吸氧、止咳、平喘、抗感染、纠正电解质和酸碱失衡等常规治疗，在对照组的基础上，静脉滴注组给予痰热清20 mL，每日1次静脉滴注给药；雾化吸入组给予痰热清注10 mL，每日1次雾化吸入给药；联合给药组给予痰热清静脉滴注联合雾化吸入给药。疗程均为7~14 d。比较4组患者的临床疗效、治疗前后肺功能和生活质量变化、住院天数、住院总费用级不良反应发生率，并用成本-效果分析对4组治疗方案进行经济学研究。结果 治疗结束后，4组治疗方案中，联合给药组的临床疗效较高、肺功能和生活质量改善优于对照组、静脉滴注组和雾化吸入组，住院天数和治疗总费用均小于对照组、静脉滴注组和雾化吸入组，均有显著性差异(P<0.05)。成本-效果分析中，对照组的C/E最大(99.56)，联合给药组的C/E最小(42.62)。结论 痰热清静脉滴注联合雾化吸入的临床疗效、安全性和经济性均较好，值得临床推广。

Study on the Clinical Efficacy and Economics of Intravenous Combined with Inhalation of Tanreqing Treatment on Moderate and Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE To study the clinical efficacy and economy of tanreqing injection with intravenous combined with inhalation compared to intravenous or inhalation alone treatment on moderate and severe acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS All of 120 patients of AECOPD from May of 2014 to May 2015 were randomly divided into control group, intravenous group, inhalation intravenous group and combined group. Control group was given oxygen, cough, asthma, anti-infection, correction of electrolyte and acid-base imbalance and other conventional treatment. On the basis of the control group, intravenous group was given Tanreqing injection(20 mL, ivgtt, qd); inhalation group was given Tanreqing injection(10 mL, whxr, qd); and combined group was given Tanreqing injection with intravenous combined with inhalation. The observation time were all 7~14 d. Comparison the difference of each group in clinical efficacy, the change of lung function and quality of life before and after treatment, length of stay hosptial, total cost of treatment and the rate of adverse drug reactions(ADR). And used cost-effectiveness analysis(CAE) to analyze economic. RESULTS After treatment, the clinical efficacy , improvement in lung function and quality of life were significant higher in the combined group than those of the control group, intravenous intravenous groupnd inhalation group(P<0.05), the days of hospitalization and the total cost of treatment were significant lower in the combined group than those of the control group, intravenous group and inhalation group , all the difference were statistically significant (P<0.05). On the cost-effectiveness analysis (CEA), C/E of control group was maximum(99.56) and combined group was minimum(42.62) among the four groups. CONCLUSION Intravenous combined with inhalation of Tanreqing injection for AECOPD is good clinical efficacy, safety and economy, worthy of promotion in the future.