發(fā)布時(shí)間：2018-06-02 23:40

  本文選題：類(lèi)風(fēng)濕關(guān)節(jié)炎 + 藥物經(jīng)濟(jì)學(xué)�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:類(lèi)風(fēng)濕關(guān)節(jié)炎(Rheumatoid Arthritis,RA)是一種慢性自身免疫性疾病,會(huì)引起疼痛、晨僵、進(jìn)行性關(guān)節(jié)破壞和殘疾,極大地威脅著人類(lèi)的身心健康。工作能力的喪失和過(guò)早的退休引發(fā)了巨大的社會(huì)代價(jià)。目前藥物治療主要包括非甾體抗炎藥(non-steroidal anti-inflammatory drugs,NSAIDs)、改善病情抗風(fēng)濕藥(disease-modifying anti-rheumatic drugs,DMARDs)、糖皮質(zhì)激素、生物制劑等。藥物經(jīng)濟(jì)學(xué)(Phamacoeconomics,PE)是近年來(lái)新發(fā)展起來(lái)的一門(mén)交叉學(xué)科,它主要任務(wù)是描述和分析藥物治療與藥學(xué)服務(wù)的成本和效果以及對(duì)個(gè)人、衛(wèi)生保健系統(tǒng)和社會(huì)的影響。方法:收集并記錄首診時(shí)采用單用來(lái)氟米特(Leflunomide,LEF),聯(lián)用甲氨蝶呤(Methotrexate,MTX)及LEF,聯(lián)用MTX及益賽普,聯(lián)用LEF及益賽普,聯(lián)用MTX、LEF及益賽普,聯(lián)用MTX、LEF及恩利6種治療方案中某一種治療方案的共95例患者的個(gè)人信息、一般情況及病情,同時(shí)密切隨訪(fǎng),患者治療期間規(guī)律用藥。分別于每位患者首次、3個(gè)月末和6個(gè)月末時(shí)就診及隨訪(fǎng)時(shí)收集數(shù)據(jù)資料,并在研究結(jié)束后對(duì)其進(jìn)行回顧性統(tǒng)計(jì)分析。結(jié)果:1.若用DAS28評(píng)分作為評(píng)價(jià)標(biāo)準(zhǔn),則在3個(gè)月療程中,LEF+益賽普組、MTX+LEF+益賽普組、MTX+LEF+恩利組療效最佳;在6個(gè)月療程中,MTX+LEF+益賽普組與MTX+LEF+恩利組療效最好且MTX+LEF+益賽普組最具成本效果比。2.若用HAQ評(píng)分作為評(píng)價(jià)標(biāo)準(zhǔn),則在3個(gè)月及6個(gè)月療程中,MTX+LEF+益賽普組與MTX+LEF+恩利組療效最好且在3個(gè)月療程中只有MTX+LEF+益賽普組最具成本效果比。3.MTX+益賽普組、LEF+益賽普組、MTX+LEF+益賽普組和MTX+LEF+恩利組治療后3個(gè)月所花費(fèi)的總成本明顯低于前3個(gè)月所花費(fèi)的總成本(P0.05)。結(jié)論:1.使用MTX+LEF+益賽普及MTX+LEF+恩利治療RA療效最佳。2.在6個(gè)月的療程中,MTX+益賽普、LEF+益賽普、MTX+LEF+益賽普及MTX+LEF+恩利后診療總成本會(huì)隨時(shí)間增加。3.無(wú)論使用DAS28或者HAQ評(píng)分作為評(píng)分標(biāo)準(zhǔn),使用MTX+LEF+益賽普方案治療3或6個(gè)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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R593.22

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