中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9867-9872.doi: 10.3969/j.issn.2095-4344.2012.52.032

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

盐酸/硫酸氨基葡萄糖治疗膝骨关节炎的成本效果分析

张百挡1,梁祖建1,张还添2,何铭涛1,黎东生3   

  1. 1广州中医药大学附属骨伤科医院,广东省广州市 510240
    2暨南大学附属第一医院骨科,广东省广州市 510630
    3广州中医药大学经济与管理学院,广东省广州市 510405
  • 收稿日期:2012-04-23 修回日期:2012-07-26 出版日期:2012-12-23 发布日期:2012-12-23
  • 通讯作者: 梁祖建,博士,副主任医师,广州中医药大学附属骨伤科医院,广东省广州市 510240 liangzujian@gzucm.edu.cn
  • 作者简介:张百挡★,男,1973年生,河南省郑州市人,汉族,2003年广州中医药大学毕业,硕士,主治医师,主要从事中西医结合防治老年骨关节病。 topzbd@126.com

Cost-effectiveness analysis on the treatment of knee osteoarthritis by glucosamine hydrochloride and glucosamine sulfate

Zhang Bai-dang1, Liang Zu-jian1, Zhang Huan-tian2, He Ming-tao1, Li Dong-sheng3   

  1. 1Affiliated Orthopedic Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510240, Guangdong Province, China
    2Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong Province, China
    3School of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Received:2012-04-23 Revised:2012-07-26 Online:2012-12-23 Published:2012-12-23
  • Contact: Liang Zu-jian, Doctor, Associate chief physician, Affiliated Orthopedic Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510240, Guangdong Province, China liangzujian@gzucm.edu.cn
  • About author:Zhang Bai-dang★, Master, Attending physician, Affiliated Orthopedic Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510240, Guangdong Province, China topzbd@126.com

摘要:

背景:膝骨关节炎的治疗通常是一个长期用药的过程,所需费用较高,因此选用合理的治疗方案至关重要。
目的:比较盐酸氨基葡萄糖、硫酸氨基葡萄糖治疗膝骨关节炎的成本-效果,进行经济学评价,为临床提供有效、实用治疗方案。
方法:将78例膝骨关节炎患者随机均分为口服盐酸氨基葡萄糖组和硫酸氨基葡萄糖组。观察治疗第3,6周两组骨关节炎指数和Lequesne疼痛与功能指数并运用药物经济学方法进行成本-效果分析。
结果与结论:膝骨关节炎治疗后两组患者各指标进行比较:①总有效率:第3周分别为83.8%和82.1%,第6周的总有效率分别为91.9%和90.7%。②成本-效果比:第3周分别为6.24和5.37,第6周分别为11.38和9.70。③敏感度分析:第3周分别为5.30和4.55,第6周分别为9.67和8.24。说明盐酸氨基葡萄糖与硫酸氨基葡萄糖均能明显地改善膝骨关节炎患者的关节炎指数及膝关节功能,但硫酸氨基葡萄糖有更好的成本-效果比。因此,硫酸氨基葡萄糖能比盐酸氨基葡萄糖以更少治疗成本获得更大的效益。

关键词: 盐酸氨基葡萄糖, 硫酸氨基葡萄糖, 膝骨关节炎, 骨关节炎指数, Lequesne疼痛, WOMAC, 成本-效果, 敏感度, 非类固醇抗炎药, 用药方案

Abstract:

BACKGROUND: Most patients of knee osteoarthritis need a long-term medication, so the costs are very high. Therefore, it is much important to choose the rational treatment project.
OBJECTIVE: To compare the cost-effectiveness of glucosamine hydrochloride and glucosamine sulfate for the treatment of knee osteoarthritis and to perform the economic evaluation in order to present more effective and utility strategy to treat osteoarthritis.
METHODS: Totally 78 outpatients with knee osteoarthritis were randomly divided into A group (n=39, treated with glucosamine hydrochloride) and B group (n=39, treated with glucosamine sulfate). The Western Ontario McMaster index as well as Lequesne pain and function index were observed at 3 and 6 weeks after treatment, and the cost-effectiveness analysis was performed with medical economical study.
RESULTS AND CONCLUSION: Comparison of the curative effect of two groups after treatment: ①Total effective rates: the total efficiencies for the treatment of osteoarthritis in group A and group B at 3 weeks after treatment were 83.8% and 82.1% respectively (P > 0.05), and at 6 weeks after treatment, the total efficiencies were 91.9% and 90.7% respectively (P > 0.05); ②Cost-effectiveness analysis: the cost-effectiveness ratios in group A and group B at 3 weeks after treatment were 6.24 and 5.37 respectively, and at 6 weeks, the cost-effectiveness ratios were 11.38 and 9.70 individually. ③Sensitiveness analysis: effective sensitiveness degrees in the two groups at 3 weeks after treatment were 5.30 and 4.55, and at 6 weeks were 9.67 and 8.24 respectively. This shows that both glucosamine hydrochloride and glucosamine sulfate have the capacity to improve Western Ontario McMaster index and knee joint function of the patients with knee osteoarthritis markedly, but the cost-effectiveness ratio of glucosamine sulfate is better than that of glucosamine hydrochloride. Therefore, glucosamine sulfate costs less medical resources and gain more effectiveness.

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