CAJ | 학술논문

目的：评价醒脑静和胞二磷胆碱治疗脑出血的成本－效果，构建临床决策模型，为其临床安全合理用药提供参考。方法效果指标采用文献分析法计算总有效率，通过对已有研究的间接分析获得；成本指标包括直接医疗成本和非直接医疗成本，通过广州某三甲医院治疗和收费标准统计获得。并以药价下调15％和护理费用上调10％进行敏感性分析。结果醒脑静和胞二磷胆碱治疗脑出血的总有效率分别为93.8％，84.55％；成本效果比分别为130.83和144.92，敏感性分析结果显示，当取消15％的药品加成后，成本效果比131.52和144.4；当护理费增加10％后，成本效果比为132.4和145.12。结论从临床经济学和社会效益角度出发，建议在针对脑出血患者的急救治疗时可采用醒脑静方案。
목적：평개성뇌정화포이린담감치료뇌출혈적성본－효과，구건림상결책모형，위기림상안전합리용약제공삼고。방법효과지표채용문헌분석법계산총유효솔，통과대이유연구적간접분석획득；성본지표포괄직접의료성본화비직접의료성본，통과엄주모삼갑의원치료화수비표준통계획득。병이약개하조15％화호리비용상조10％진행민감성분석。결과성뇌정화포이린담감치료뇌출혈적총유효솔분별위93.8％，84.55％；성본효과비분별위130.83화144.92，민감성분석결과현시，당취소15％적약품가성후，성본효과비131.52화144.4；당호리비증가10％후，성본효과비위132.4화145.12。결론종림상경제학화사회효익각도출발，건의재침대뇌출혈환자적급구치료시가채용성뇌정방안。
Objective To establish a clinical decision model and make a cost -effectiveness analyses of Xingnaojing injection in the treatment of spontaneous intracerebral hemorrhage ( SIH) compared with Citicoline , and provide a reference for the rational and safe use of drugs for SIH .Methods Total effective rate was regarded as ef-fectiveness index , which were gained by analyzing the literatures reported the treatment of SIH using Citicoline or Xingnaojing injection .Expected total cost was regarded as cost index , which were gained by analyzing the cost data of a certain grade-three general hospital in Guangzhou .A sensitivity analysis was made , with prices of drug falling by 15%and fees of nursing rising by 10%.Results Total effective rate of the treatment of SIH using Xingnaojing in-jection and Citicoline were 93.8%, 84.55%.Therefore, the ratio of cost and effect (C/E) were 130.83 and 144. 92 respectively .Sensitivity analysis showed that C/E of the treatment of SIH using Xingnaojing injection and Citico-line were 131.52 and 144.4 when the prices of drug falling by 15%.C/E were 132.4 and 145.12 when the fees of nursing rising by 10%.Conclusion From the clinical economics evaluation and social benefits , therapeutic sched-ule of Xingnaojing injection was advised to use in treating SIH .