95例类风湿关节炎门诊患者成本效果的回顾性分析

发布时间：2018-06-02 23:40

本文选题：类风湿关节炎 + 药物经济学　；参考：《山西医科大学》2017年硕士论文

【摘要】：背景:类风湿关节炎(Rheumatoid Arthritis,RA)是一种慢性自身免疫性疾病,会引起疼痛、晨僵、进行性关节破坏和残疾,极大地威胁着人类的身心健康。工作能力的丧失和过早的退休引发了巨大的社会代价。目前药物治疗主要包括非甾体抗炎药(non-steroidal anti-inflammatory drugs,NSAIDs)、改善病情抗风湿药(disease-modifying anti-rheumatic drugs,DMARDs)、糖皮质激素、生物制剂等。药物经济学(Phamacoeconomics,PE)是近年来新发展起来的一门交叉学科,它主要任务是描述和分析药物治疗与药学服务的成本和效果以及对个人、卫生保健系统和社会的影响。方法:收集并记录首诊时采用单用来氟米特(Leflunomide,LEF),联用甲氨蝶呤(Methotrexate,MTX)及LEF,联用MTX及益赛普,联用LEF及益赛普,联用MTX、LEF及益赛普,联用MTX、LEF及恩利6种治疗方案中某一种治疗方案的共95例患者的个人信息、一般情况及病情,同时密切随访,患者治疗期间规律用药。分别于每位患者首次、3个月末和6个月末时就诊及随访时收集数据资料,并在研究结束后对其进行回顾性统计分析。结果:1.若用DAS28评分作为评价标准,则在3个月疗程中,LEF+益赛普组、MTX+LEF+益赛普组、MTX+LEF+恩利组疗效最佳;在6个月疗程中,MTX+LEF+益赛普组与MTX+LEF+恩利组疗效最好且MTX+LEF+益赛普组最具成本效果比。2.若用HAQ评分作为评价标准,则在3个月及6个月疗程中,MTX+LEF+益赛普组与MTX+LEF+恩利组疗效最好且在3个月疗程中只有MTX+LEF+益赛普组最具成本效果比。3.MTX+益赛普组、LEF+益赛普组、MTX+LEF+益赛普组和MTX+LEF+恩利组治疗后3个月所花费的总成本明显低于前3个月所花费的总成本(P0.05)。结论:1.使用MTX+LEF+益赛普及MTX+LEF+恩利治疗RA疗效最佳。2.在6个月的疗程中,MTX+益赛普、LEF+益赛普、MTX+LEF+益赛普及MTX+LEF+恩利后诊疗总成本会随时间增加。3.无论使用DAS28或者HAQ评分作为评分标准,使用MTX+LEF+益赛普方案治疗3或6个月均最具成本效果比。
[Abstract]:Background: rheumatoid arthritis (RA) is a chronic autoimmune disease, which can cause pain, morning stiffness, progressive joint destruction and disability. Loss of ability to work and early retirement carry enormous social costs. At present, drug therapy mainly includes non-steroidal anti-inflammatory drug drugs NSAIDsN, improving the disease of anti-rheumatic drugs such as anti-rheumatic drug DMARDsN, glucocorticoid, biological agents and so on. PhamacoeconomicsPE) is a newly developed interdisciplinary subject in recent years. Its main task is to describe and analyze the cost and effectiveness of drug treatment and pharmaceutical services and its impact on individuals, health care systems and society. Methods: to collect and record the first diagnosis with Leflunomide leefin, methotrexate MTX and LEF, MTX and Issup, LEF and Isepp, MTXL Lef and Isop, MTXX Leflon Lef and Isop, and methotrexate. The personal information, general condition and condition of 95 patients who were treated with MTXL Lef and Enli in one of the six treatments were followed up closely, and the regular medication was used during the treatment. The data were collected at the first month, the third month and the sixth month, respectively, and the data were analyzed retrospectively after the end of the study. The result is 1: 1. If the DAS28 score was used as the evaluation criterion, the best therapeutic effect was obtained in the three months course of treatment in the Lef Isop group and the MTX LEF LEF Enri group. In the 6-month course of treatment, the MTX LEF Isop group and the MTX LEF Enri group had the best curative effect and the MTX LEF Yisepp group had the most cost-effective ratio of .2. If the HAQ score is used as the evaluation criterion, In 3 months and 6 months of treatment, MTX LEF Isop group and MTX LEF Enri group had the best curative effect, and only MTX LEF Yisepp group had the most cost effect ratio of 3 months. 3. MTX LEF Iseptide group and MTX LEF Yisepp group The total cost of Enli group 3 months after treatment was significantly lower than that of the previous 3 months (P 0.05). Conclusion 1. MTX LEF Iseptide and MTX LEF Enri have the best curative effect on RA. After 6 months of treatment, the total cost of diagnosis and treatment of MTX Isoproprin, Lef Isepril, MTX LEF and MTX LEF Enri will increase with time. Whether the DAS28 or HAQ score was used as the scoring standard, the use of the MTX LEF Isop regimen for 3 or 6 months was the most cost effective.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.22

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