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目的:观察基于临床路径的以中医非药物疗法为主的中西医结合治疗颈性眩晕患者的近期疗效及药物经济学情况。方法:将82例出现短暂性脑缺血发作的颈性眩晕患者按随机单盲法分为治疗组52例和对照组30例。在常规基础上,对照组给予甲磺酸倍他司汀片12mg,一日3次,饭后口服。3天后减量至6mg。治疗组给予1234取穴法针刺治疗:大椎、风池、大柕、颈夹脊、四神聪。平补平泻,每日1次。所有患者均给予临床路径管理。观察治疗前后ESCV评分,记录症状缓解时间及住院时间。于出院后进行成本-效果比分析。结果:两组总有效率为92.31%vs76.66%,ESCV改善率为86.99%vs78.53%。第4天ESCV评分为23.37±2.16vs19.66±2.27,症状缓解时间为2.65±1.03vs3.53±1.28天。两组比较,差异有统计学意义(P<0.05)。与治疗组比较,对照组每获得一个ESCV评分,需多花费241.38元;每增加1天住院时间,需多花费365.44元;每多获得1个单位的疗效,需多花费30.86元。敏感度分析后结果仍如此。结论:基于临床路径的1234取穴法中西医结合治疗颈性眩晕,可以提高疗效,缩短症状缓解时间,提高生活质量。能够降低成本-效果比,更符合药物经济学原则。
OBJECTIVE: To observe the short-term curative effect and pharmacological economics of patients with cervical vertigo based on clinical pathways based on TCM non-drug therapy. Methods: 82 patients with transient ischemic attack of cervical vertigo were randomly divided into treatment group (52 cases) and control group (30 cases). On a routine basis, the control group was given betahist methanesulfonate tablet 12mg three times a day orally after meals. Reduce to 6mg after 3 days. The treatment group was given acupuncture treatment of 1234 acupoints: Ojo, the wind pool, Ota, Jiaji ridge, Sishencong. Pingxie diarrhea, 1 day. All patients were given clinical pathway management. The score of ESCV was observed before and after treatment, and the symptom relief time and hospital stay were recorded. Cost-effectiveness analysis after discharge from hospital. Results: The total effective rate of two groups was 92.31% vs 76.66%, and the improvement rate of ESCV was 86.99% vs78.53%. On the fourth day, the ESCV score was 23.37 ± 2.16 vs 19.66 ± 2.27 and the symptom relief time was 2.65 ± 1.03 vs 3.53 ± 1.28 days. The difference between the two groups was statistically significant (P <0.05). Compared with the treatment group, each control group received an ESCV score, need to spend 241.38 yuan more; for each additional day hospitalization, need to spend 365.44 yuan more; get 1 unit for each effect, need to spend 30.86 yuan. The result of the sensitivity analysis remains the same. Conclusion: Based on the clinical path of 1234 acupoints combined with traditional Chinese and Western medicine treatment of cervical vertigo, can improve the curative effect, shorten the symptom relief time and improve the quality of life. Can reduce the cost - the effect is more in line with the principles of drug economics.