丹参川芎嗪注射液联合厄贝沙坦治疗糖尿病肾病的成本-效果分析

摘要

目的:评价丹参川芎嗪注射液联合厄贝沙坦在糖尿病肾病治疗中的成本-效果.方法:将76例糖尿病肾病患者随机均分为治疗组与对照组:在积极控制血糖的基础上,治疗组在持续口服厄贝沙坦片的同时加用丹参川芎嗪注射液静脉滴注(连用14d),对照组单用厄贝沙坦片,疗程均为12周.观察两组治疗前后血压、血尿素氮(BUN)、血清肌酐值(Scr)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、尿微量白蛋白排泄率(UAER),运用成本-效果分析法进行分析和比较.结果:与治疗前比较,两组治疗后血压、BUN、Scr和UAER均显著下降(P＜0.05或P＜0.01),且与对照组比较治疗组降低更为显著(P＜0.05或P＜0.01).治疗组治疗后TG、TC显著下降,HDL-C升高(P＜0.01),而对照组治疗前、后无显著变化(P＞0.05).治疗组与对照组的总有效率分别为89.47％和65.79％(P＜0.05),成本分别为(6 468.34±2 376.53)元和(5 482.64±486.67)元,成本-效果比分别为7 229.62和8 333.55,以对照组为参照,治疗组的增量成本-效果比为41.63.结论:厄贝沙坦联合丹参川芎嗪治疗糖尿病肾病可以降低血压,减少蛋白尿,降低TG、TC、UAER水平,升高HDL-C水平,稳定肾功能,疗效优于单用厄贝沙坦,是治疗糖尿病肾病的较好组合,且其治疗成本未显著增加.%OBJECTIVE: To evaluate the cost-effectivness of Salviae miltiorrhizae and ligustrazine hydrochloride injection combined with irbesartan in the treatment of diabetic nephropathy. METHODS: 76 cases of patients with diabetic nephropathy were randomly divided into treatment group and control group, 38 cases in each group. Based on the positive control blood sugar, the treatment group on the basis of continuous oral irbesartan tablets + Salviae miltiorrhizae and ligustrazine hydrochloride injection, ivgtt. (use 14 d), the control group was treated with oral irbesartan tablets for 12 weeks, observed before and after treatment, blood pressure, BUN, Scr, TG, TC, HDL-C, UAER, to analyze and compare the cost-effectiveness. RESULTS: Compared with before treatment in both groups, blood pressure, BUN, Scr and UAER were significantly decreased (P<0.05 or P<0.01), the treatment group compared with the control group decreased more significantly(P<0.01). After treatment, TG, TC significantly decreased, HDL-L increased (P<0.01), before and after treatment of the control group had no significant change (P>0.05). The treatment group and the control group, the total efficiency were 89.47% and 65.79%, respectively (P<0.05), the cost were (6 468.34±2 376.53 yuan and (5 482.64±486.67) yuan, cost-effectiveness ratio were 7 229.62 and 8 333.55, respectively. To the control group as a reference, the incremental cost-effectiveness of the treatment group was 41.63. CONCLUSIONS: Salviae miltiorrhizae and ligustrazine hydrochloride injection combined with Irbesartan in the treatment of diabetic nephropathy can lower blood pressure , reduce proteinuria, lower TG, TC, UAER in increasing HDL-C, stable renal function, more effective than the single use of irbesartan, and is a good combination, cost-effectiveness analysis results had no significantly increase.