MECT（无抽搐电休克）与利培酮通治疗精神分裂症的成本-效果分析

目的探讨MECT（无抽搐电休克）与维思通治疗精神分裂症的成本与疗效。方法对我院2008年5月到2010年5月的住院的64例精神分裂症患者随机分为MECT（无抽搐电休克）组（32例）和维思通组（32例）。疗程均为12周,采用阳性和阴性症状量表（PANSS）,副反应量表（TESS）,在治疗前及治疗后1,2,4,8,12周末分别评定疗效及副反应,并用最小成本分析法进行研究。结果治疗2周末,MECT（无抽搐电休克）组的PANSS总分即比较治疗前有显著下降（P〈0.05）;维思通组在治疗4周末的PANSS总分比较治疗前有显著下降（P〈0.05）;4周末起各时点PANSS评分两组之间减分差异无统计学意义（P〉0.05）。治疗12周末,MECT（无抽搐电休克）组有效率为75%;维思通组有效率为69%。两者之间差异无统计学意义（P〉0.05）。两组均未发生严重的不良反应。两方案治疗精神分裂症成本分别为9454.35元、9772.78元;每获得一个单位的效果,两种方案所需花费的成本分别为126.06元、141.63元。结论 MECT（无抽搐电休克）与维思通治疗精神分裂症的成本-效果相当,MECT（无抽搐电休克）组起效更快,副反应更少。

Cost-effectiveness analysis of MECT and risperridone on the treatment of schizophrenia

OBJECTIVE To discuss the economic effects or different therapeutic schemes in the treatment of schizophrenia.METHODS A total of 64 patients with schizophrenia were randomly assigned to MECT group and risperidone group,and received risperidone or MECT treatment for 12 weeks respectively.The efficacy and adverse events were assessed with the positive and negative syndrome scale(PANSS),and treatment emergent symptom scale(TESS) at week 0 and 1,2,4,8,12.the effect and costs of two therapies were compared with the pharmacoeconomic cost-effectiveness analysis.RESULTS The PANSS scores in mect group deecreased significantly after reatment 2 weeks(P<0.05).the PANSS scores in risperidone group decreased significantly after reatment 4 weeks(P<0.05).the PANSS total score and negative syndrome score in both groups were not significantat at each time point from 4th weekend after treatment(P>0.05).By the end of week 12,total clinical effective rates were 75% in MECT group and 69% in risperido group,without any statiscally singnificant difference between the two groups.no severe adverse events were reported in both group.the costs of two groups were 9454.35yuan and 9772.78yuan.CONCLUSION MECT has similar costs to risperidone in the antipsychotic treatment.MECT taking effect more quickly and less side effects.