The rotating manipulative therapy nerve root type cervical spondylosis clinical efficacy evaluation and cost - effectiveness analysis
|School||China Academy of Traditional Chinese Medicine|
|Course||Traditional Chinese Medicine|
|Keywords||XuanZhuanShouFa Cervical Spondylopathy CEA|
Health Economic Evaluation is an evaluation method that evaluate the value of treatments in economic. It becomes an assistant of decision-making that how to make good use of the medicine resources. Health Economic Evaluation using in clinical curative-effect evaluation of TCM is experiment. Studies on the Health Economic Evaluation using in clinical curative-effect evaluation of TCM are few. The features and advantages of treatments by TCM are not only curative-effect, but also the value in economy.Aim: By control with traction, the normal treatment in modern medicinal, evaluate the clinical curative-effect and safety of using the XuanZhuanShouFa to treat the cervical spondylopathy. As the same time to dig the value in economic by health economic evaluation.Objects: All the patients are from Wangjing hospital, Beijing Electricity hospital , Shanghai Yueyang hospital, Zhuhai hospital during September of 2005 to April of 2006. There are 69 patients accord with the diagnose criterion 、 bring into criterion and exclude criterion. There are 36 patients in the Shoufa team, and 33 patients in the traction team.Method: Both Shoufa team and traction team accept 14-days treatment. Patients in Shoufa team accept 7 times treat and traction team doubled. There are 7 interviews in the CRF, and the outcomes of 1st , 4th, 7th is the data of clinical curative-effect evaluation. The main symptom are pain of neck and shoulder, pain of neck, the activity of neck vertebra;the subordination symptoms are upper limbs anaesthesia, power of upper limbs and so on. The clinical curative-effect evaluation is symptom score difference and index of curative-effect. The method of health economic evaluation is cost-effectiveness analysis. The direct cost in medicine concludes fee of registration fee, the fee of Shoufa treatment and the fee of traction treatment. The direct cost in non-medicine is cost of traffic. Overhead cost is charge for loss of working time. The total cost is the sum of direct cost in medicine, direct cost in non-medicine and overhead cost. The final effect outcome is the 7th main symptom, subordination symptom , total symptom score improvement and index of curative effect. Comparing the cost effectiveness rate between the two groups, as the same time the incremental analysis.In the study, using the x2test of CMH x2test to deal with disperse data. All the continuum data should test the normality. The data that pass the normality test and the test of equality of variances use the t test. If the variances of two teams are not equal, the method of statistic is t’ test. The data that are not normal distributing should use the Wilcoxon rank test. If the p value less than 0. 05, it means that the difference is signature in statistics. The statistic software is SAS 8. 0oOutcome: There are 36 patients in Shoufa team and 33 patients in traction team. Comparing with two teams in sex , age , course of diseases, scores of main symptom, scores of the subordination symptoms, scores of total symptoms, all the P value are more than 0.05, the differences are no signature in statistics. There are no signature in statistics in the symptom of pain of neck and shoulder on all the interviews between two teams. On the 1st interview , the symptom of pain of neck has signature in statistics. The activity of neck vertebra has signature in statistics on the 1st, 4lh interview. On the Is’ , 7th interview, the main symptom has signature in statistics. All the symptoms’ curative effect index have signature in statistics.The CEA bases on the outcome of curative effect. The cost of direct medicine of Shoufa team is 12026 yuan. The traction team is 13384 yuan. The cost of direct non-medicine in Shoufa team is 686 yuan and traction team is 1120 yuan. The total cost of charge for loss of working time in Shoufa team is 12775 yuan, traction team is 21700 yuan. The sum cost of the two teams is 25487 yuan and 36204 yuan. The average cost of the two teams is 708 yuan and 1097 Yuan. The cost of Shoufa team is lower than traction team. In the main symptom , the subordination symptoms and the total symptoms of Shoufa team, the cost effectiveness rates are 86. 98, 175. 68, 58. 18. The cost effectiveness rates of traction team in main symptom, the subordination symptoms, total symptoms arel81. 92, 453. 31, 129. 82. The Shoufa team is lower than traction team. It means Shoufa team is better than traction team in economic. The cost effectiveness rates of curative effect index of Shoufa team are 11.88, 12.90, 12.01. Traction team are 25.16, 25.87, 25.28. Comparing with Shoufa team, Traction team in main symptom, the subordination symptoms, total symptoms’ cost effectiveness rates are -184. 36, -241.62, -104.57. The cost effectiveness rates of curative effect index of traction team are -24.30, -31.10, -25. 03. All the cost effectiveness rates are less than 0. In the incremental analysis, Shoufa team is better than traction team.Conclusion: By the study we found that the curative effect of XuanZhuanShouFais better than traction which is normal in Western medicine. What’ s more there are no adverse events. According to the CEA, the XuanZhuanShouFa has well value in economics. So the method is a better curative effect and lower cost therapy.