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目的:评价三种治疗方案对于Ⅲ-Ⅳ期非小细胞肺癌(NSCLC)的疗效和生存获益,并进行成本效益分析。方法:采用前瞻性、随机、对照研究方法,将Ⅲ-Ⅳ期NSCLC首治带瘤患者随机分为化疗组和中医综合方案组,并同期入组中医治疗患者。以有效率、疾病控制率、生存期及毒副反应作为衡量指标观察三种方案治疗1个疗程后的经济成本效益。结果:共入组73例患者,中医组、化疗组、中医综合组分别为21例、25例、27例;3组经济成本分别为17448.38元、19424.96元、23008.24元;有效率的成本/效果比分别为-、4856.24、1438.02;疾病控制率的成本/效果比分别为1246.31、693.74、719.00;生存期的成本/效果比分别为28.84、33.21、24.61。增量分析法提示以中医治疗作为参照,化疗组及中医综合组的△C/△E有效分别为494.15、347.49、△C/△E疾病控制分别为141.18、308.88;以化疗组作为参照,中医组及中医综合组的△C/△E生存期分别为-1744.84、10.24。结论:中医药治疗Ⅲ、Ⅳ期NSCLC是一种经济、有效的治疗方案。如果经济条件允许,可选择中西医结合治疗,可获得更好的有效率及较长的生存期。
OBJECTIVE: To evaluate the efficacy and survival benefit of the three treatment regimens for stage III-IV non-small cell lung cancer (NSCLC) and to conduct a cost-benefit analysis. Methods: A prospective, randomized, controlled study was conducted to divide the patients with stage Ⅲ-Ⅳ NSCLC into the chemotherapy group and the integrated traditional Chinese medicine group randomly. Patients in the same period were enrolled in the TCM treatment group. With the efficiency, disease control rate, survival and toxicity as a measure to observe the three programs for the treatment of a course of economic cost-effectiveness. Results: A total of 73 patients were enrolled in the study. The Chinese medicine group, chemotherapy group and traditional Chinese medicine group were 21 cases, 25 cases and 27 cases respectively. The economic costs of the three groups were 17448.38 yuan, 19,424.96 yuan and 23008.24 yuan respectively. The cost / effect 4856.24 and 1438.02, respectively. The cost-effectiveness ratios of disease control rates were 1246.31, 693.74 and 719.00, respectively. The cost-effectiveness ratios of survival were 28.84, 33.21 and 24.61, respectively. The incremental analysis method suggested that TCM treatment was taken as a reference. The △ C / △ E effective rates of chemotherapy group and traditional Chinese medicine group were 494.15 and 347.49, respectively. The disease control of △ C / △ E was 141.18 and 308.88, respectively. The △ C / △ E survival rates of the combined TCM and TCM groups were -1744.84 and 10.24, respectively. Conclusion: Chinese medicine treatment of stage Ⅲ, Ⅳ NSCLC is an economical and effective treatment. If the economic conditions permit, you can choose Integrative Medicine, get better efficiency and longer survival.