| 邱怀德,陆 晓,刘守国,王 萌,励建安.藏药药浴应用于脑卒中康复的卫生经济学评价[J].中国康复医学杂志,2018,(12):1434~1439 |
| 藏药药浴应用于脑卒中康复的卫生经济学评价 点此下载全文 |
| 邱怀德 陆 晓 刘守国 王 萌 励建安 |
| 南京医科大学第一附属医院，南京，210029 |
| 基金项目：“十二五”国家科技支撑计划（2013BAI10B04） |
| DOI： |
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| 摘要
目的：探讨藏药药浴应用于脑卒中康复的经济学价值。
方法：基于多中心随机对照试验，本研究纳入脑卒中患者403例，入组患者随机分为常规康复组202例和藏药药浴组201例（常规康复加藏药药浴）。两组患者均接受常规康复治疗标准方案，包括常规物理治疗60min/d，强化抗痉挛治疗60min/d，作业治疗30min/d，每周5天，治疗4周。藏药药浴组在常规康复治疗基础上，加用藏药药浴20min/d，每周5天，治疗4周。采用Fugl-Meyer评分（FMA）、改良Barthel评分（MBI）分别在治疗前、治疗2周后、治疗4周后评估运动功能和日常生活活动能力，记录全部医疗花费。卫生经济学指标采用成本效果比，以直接医疗费用与FMA和MBI评分变化值的比值评价。同时计算藏药药浴组的增量成本效果比（ICER），以进一步衡量其成本效果。
结果：治疗4周后，常规康复组FMA值、MBI值较治疗前分别提高（6.92±8.48）分和（7.78±9.49）分；藏药药浴组FMA值、MBI值较治疗前分别提高（10.26±10.86）分和（11.05±12.00）分。FMA每提高1分，直接医疗费用常规康复组为3064.22元，藏药药浴组为2343.90元，较常规康复组节省720.32元；MBI评分每提高1分，常规康复组直接医疗费用为2725.51元，藏药药浴组为2176.33元，较常规康复组节省549.18元。ICER分析结果也提示藏药药浴组较常规康复组具有更好成本效果。
结论：脑卒中常规康复结合藏药药浴的综合治疗比单纯常规康复治疗具有更好的成本效果。 |
| 关键词：脑卒中 藏药药浴 成本效果 |
| Health economics evaluation of Tibetan medicine bath therapy for post-stroke rehabilitation Download Fulltext |
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| Department of Rehabilitation Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing,210029 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: To assess the economic value of Tibetan medicine bath for post-stroke rehabilitation.
Method: A total of 403 stroke patients were randomly divided into two groups: routine rehabilitation group (202 patients) and Tibetan medicine bath group (201 patients) which combined routine rehabilitation treatment with Tibetan medicine bath. Both groups received the standard program of routine rehabilitation, including conventional physical therapy 60min/d, intensive anti-spastic treatment 60min/d, occupational therapy 30min/d, 5 days a week for 4 weeks. Tibetan medicine bath group received Tibetan medicine bath 20min/d, 5 days a week for 4 weeks on the basis of conventional rehabilitation. The Fugl-Meyer score (FMA) and modified Barthel score (MBI) were used to assess motor function and activities of daily living before treatment, 2 weeks and 4 weeks during treatment respectively. All medical expenses were recorded and analyzed. The cost-effectiveness was evaluated as the ratio of the direct medical cost vs changes in the FMA and MBI scores. Incremental cost effectiveness ratio (ICER) was calculated to assess the cost effectiveness of Tibetan medicine bath therapy.
Result: After 4 weeks of treatment, the FMA value and MBI value of routine rehabilitation group increased by 6.92 ± 8.48 and 7.78 ± 9.49 points respectively compared with baseline; the FMA and MBI values of Tibetan medicine bath group increased by 10.26 ± 10.86 and 11.05 ± 12.00 points respectively. For every point increase in Fugl-Meyer score, the direct medical cost of the rehabilitation group was 3064.22 yuan and the bath group was 2343.90 yuan, which was 720.32 yuan less than the former; For each point increase in the Modified Barthel Index, the direct medical cost of routine rehabilitation group was 2725.51 yuan, and the bath group was 2176.33 yuan, which was 549.18 yuan less than the former. The results of ICER analysis also indicated that Tibetan medicine bath group had better cost effectiveness.
Conclusion: Comprehensive rehabilitation program which consists of routine rehabilitation treatment and Tibetan medicine bath has better cost-effectiveness than routine rehabilitation alone. |
| Keywords:stroke Tibetan medicine bath cost effectiveness |
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