两种治疗2型糖尿病联合用药方案的费用-效果分析(1)
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[摘要] 目的：探讨两种常用的联合用药方案对2型糖尿病的治疗效果和经济效果。方法：选择2型糖尿病患者100例，随机分为A、B两组，每组50例，分别运用混人胰岛素联合阿卡波糖和阿卡波糖联合二甲双胍进行治疗，并对其进行费用-效果分析。结果：A组的总有效率为86%，B组的有效率为92%，两种治疗方案具有相似的临床疗效，但阿卡波糖联合二甲双胍治疗方案的费用为235.48元，明显低于应用混人胰岛素联合阿卡波糖治疗方案的费用(389.10元)，差异具有统计学意义(P<0.05)，更具有经济学价值。结论：从药物经济学考虑，两种方案中阿卡波糖联合二甲双胍治疗方案在社区治疗2型糖尿病中更为理想，值得推广。
[关键词] 2型糖尿病；社区；费用-效果分析
[中图分类号] R587.1 [文献标识码] C [文章编号] 1673-7210(2011)11(b)-138-02
Analysis on treatment cost-effect of type 2 diabetes in two combination schemes
FAN Yuxia
Health Service Center, Guangnei Community of Beijing, Beijing 100053, China
[Abstract] Objective: To discuss the treatment effect-economic effect by using two combination schemes for type 2 diabetes. Methods: 100 patients with type 2 diabetes were selected and randomly divided into group A and group B, each group had 50 cases. Two groups were respectively used mixed human insulin jointed with Acarbose and Acarbose jointed with Metformin to treat type 2 diabetes. Treatment cost-effect were analysed. Results: The total effective rate of group A was 86%, total effective rate of group B was 92%, two treatment programs had similar clinical efficacy, the cost of Acarbose jointed with Metformin was 235.48 yuan, which was significantly lower than the cost of mixed human insulin jointed with Acarbose (389.10 yuan). There was a statistically significant difference (P<0.05), and had more economic value. Conclusion: Acarbose jointed with Metformin to treat type 2 diabetes is worthy to application in the community with its ideal effect from consideration of the drug economics.
[Key words] Type 2 diabetes; Community; Treatment cost-effect analysis
糖尿病是危害人类健康和生命的主要慢性病之一，其患病率和死亡率均呈持续增长趋势。糖尿病及其并发症已成为居民致死、致残及医疗费用开支增加的主要原因之一[1]。大量研究表明，合理地应用降血糖药物，控制血糖水平，可以有效地控制糖尿病的进展及并发症的发生，从而减轻糖尿病患者的经济负担。本文选取社区常用的降血糖治疗方案治疗2型糖尿病，并对治疗方案进行费用-效果分析，旨在为社区医生的临床用药提供指导。
1 资料与方法
1.1 一般资料
本研究的目标人群均来自北京市某社区卫生服务中心管理的、符合1999年WHO诊断标准的2型糖尿病患者，且未出现并发症者，共计100例，其中，男54例，女46例，男女比例为1.17∶1.00，年龄45~75岁，平均(60.75±8.45)岁。随机将其分为A、B两组，每组50例。A组，男28例，女22例，男女比例为1.27∶1.00，患者平均年龄为(60.34±8.70)岁；B组，男26例，女24例，男女比例为1.08∶1.00，平均年龄为(61.16±8.26)岁。两组患者性别、年龄等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。所有患者均无合并心肌梗死、脑卒中、肾功能衰竭等严重并发症。
1.2 方法
本研究所选取患者均于入组前进行空腹血糖、糖化血红蛋白、血脂、空腹胰岛素、肝功能等检查，并对其身高、体重、既往糖尿病治疗史及用药情况进行调查。A组50例，给予混人胰岛素联合阿卡波糖进行治疗 ......
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