煮散剂与汤剂在肺炎喘嗽中的疗效比较和成本分析

目的比较儿科煮散剂与饮片汤剂对小儿肺炎喘嗽的临床疗效和经济成本分析，探讨中药煮散剂的成本优势。方法对2010年10月至2013年3月广东省中西医结合医院儿科病房收治的300例肺炎喘嗽患儿按风寒闭肺、风热闭肺、痰热闭肺3种证型随机分配到煮散剂组和饮片组，比较3种证型各自方剂不同剂型口服给药对患儿临床症状、体征的影响，观察煮散剂与饮片的疗效差异，探讨煮散剂口服给药的安全性。同时，对煮散剂与饮片进行临床经济成本对比评价。结果煮散剂组在小儿肺炎喘嗽3种证型中的临床疗效与饮片汤剂组比较差异无统计意义（P〉0．05），但煮散剂组在中药经济成本上明显少于饮片组。结论通过对小儿肺炎喘嗽3种证型的临床观察及对比，煮散剂在有效性、安全性方面与饮片剂型无明显差异，但在经济成本土明显优于饮片汤剂型。

Curative effect comparison and cost analysis of boiled powder and decoction in treating pneumonia asthma cough

Objective To compare clinical curative effect and economic cost of boiled powder and decoction in treating infantile pneumonia asthma cough, and to explore the cost advantage of traditional Chinese medicine. Methods 300 cases of pneumonia asthma cough patients from 2010 October to 2013 March treated in pediatric ward of Integrated Hospital of Guangdong Province were classified as wind and coldness restraining the lung, wind and heat restricting the lungs, phlegm and heat constraining the lungs which were randomly assigned to powder group and decoction group. The effects of different powder and decoction on clinical signs and symptoms of 3 kinds of syndromes were compared. Effects of powder and decoction and the safety of oral powder were studied. At the same time, the boiled powder and decoction cost comparison was made. Results There were no significant statistic difference in clinical efficacy between powder and decoction groups among the three syndromes （ P〉0.05 ） , but the cost of powder group was significantly less than that of the decoction group （ P〈0.05 }. Conclusion Through the clinical observation and comparision of 3 syndromes of pediatric pneumonia, there is no statistic significance be- tween boiled powder and decoction in effect and safety and pieces, but the cost of the powder is significantly less than that of the decoction.