本文選題：類風濕關(guān)節(jié)炎 + 藥物經(jīng)濟學　； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：背景:類風濕關(guān)節(jié)炎(Rheumatoid Arthritis,RA)是一種慢性自身免疫性疾病,會引起疼痛、晨僵、進行性關(guān)節(jié)破壞和殘疾,極大地威脅著人類的身心健康。工作能力的喪失和過早的退休引發(fā)了巨大的社會代價。目前藥物治療主要包括非甾體抗炎藥(non-steroidal anti-inflammatory drugs,NSAIDs)、改善病情抗風濕藥(disease-modifying anti-rheumatic drugs,DMARDs)、糖皮質(zhì)激素、生物制劑等。藥物經(jīng)濟學(Phamacoeconomics,PE)是近年來新發(fā)展起來的一門交叉學科,它主要任務是描述和分析藥物治療與藥學服務的成本和效果以及對個人、衛(wèi)生保健系統(tǒng)和社會的影響。方法:收集并記錄首診時采用單用來氟米特(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例患者的個人信息、一般情況及病情,同時密切隨訪,患者治療期間規(guī)律用藥。分別于每位患者首次、3個月末和6個月末時就診及隨訪時收集數(shù)據(jù)資料,并在研究結(jié)束后對其進行回顧性統(tǒng)計分析。結(jié)果:1.若用DAS28評分作為評價標準,則在3個月療程中,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評分作為評價標準,則在3個月及6個月療程中,MTX+LEF+益賽普組與MTX+LEF+恩利組療效最好且在3個月療程中只有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個月所花費的總成本明顯低于前3個月所花費的總成本(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隨時間增加。3.無論使用DAS28或者HAQ評分作為評分標準,使用MTX+LEF+益賽普方案治療3或6個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.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R593.22

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