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目的应用现代经济学计量模型方法,对中医、西医与中西医结合在治疗原发性非小细胞肺癌(ⅢB～Ⅳ期)的效果进行实证比较分析。方法数据样本取自广州6家医院2007年因原发性非小细胞肺癌(ⅢB～Ⅳ期)入院的608个临床病例,评价治疗效果的产出变量(outcomes variables)包括住院费用、Karnofsky Performance Status Scale(KPS)评分差值与临床症状,控制干扰因素变量,计量估计模型,同时还考虑了包括样本选择误差(sample selection bias)等组间的非观察性影响因素。结果在其他条件相同的情况下,中医和中西医结合治疗非小细胞肺癌(ⅢB～Ⅳ期)的住院费用比西医治疗分别要低62.95%和28.51%(P<0.01);提升患者KPS评分等级的OR值分别是西医治疗的3.19倍和2.16倍;另外,在细分症状指标好转率方面,中医与中西医结合也体现出一定的好转优势。结论中医药在治疗非小细胞肺癌方面确有比较优势。有关中医药在治疗其他病种上的潜在优势,可以借助现代计量经济模型的实证方法,进行科学、客观的比较分析,发挥其应有的作用,促进医疗资源的配置效率和国民健康福利的提高。
Objective To compare and analyze the effect of combination of traditional Chinese medicine, western medicine and traditional Chinese and western medicine on the treatment of primary non-small cell lung cancer (stage ⅢB-Ⅳ) with modern econometric model. METHODS Data samples were obtained from 608 clinical cases hospitalized in 6 hospitals in Guangzhou in 2007 for primary non-small cell lung cancer (stage ⅢB-Ⅳ). The outcomes variables for assessing treatment outcome included hospitalization costs, Karnofsky Performance Status Scale (KPS) score differences and clinical symptoms, variables controlling the disturbance variables, and the model of econometric estimation, as well as non-observer factors including sample selection bias. Results Under the same conditions, the hospitalization costs of TCM and Integrative Medicine for non-small cell lung cancer (stage ⅢB-Ⅳ) were 62.95% and 28.51% lower than those of Western medicine respectively (P <0.01), and the KPS grade The OR values were 3.19 times and 2.16 times that of Western medicine respectively. In addition, the combination of TCM and Western medicine also showed some improvement in the improvement rate of sub-symptom index. Conclusion Chinese medicine in the treatment of non-small cell lung cancer does have a comparative advantage. With regard to the potential advantages of traditional Chinese medicine in the treatment of other diseases, the comparative analysis of science and objective can be conducted scientifically and objectively with the help of the empirical methods of modern econometric models, giving full play to their due functions and promoting the allocation of medical resources and the enhancement of national health benefits .