Clinical Pathway To Treat Allergic Rhinitis With Traditional Chinese Medicine:Cost Control And Effective Evaluation

This research is to evaluate the TCM (Traditional Chinese Medicine)clinical pathway of allergic rhinitis.It is consist of clinical effect, result and feasibility. With this research we can offer more clinical proof that can make TCM curative effect objectively and standardization. Research method, result, conlusionResearch method:Patients are observerd in7hospitals including the First Affiiated Hospital of Guangzhou University of TCM and so on. All patients are divided to clinical pathway group and non-clinical pathway group. The non-clinical pathway group is also divded into western medicine group and desensitization group.The factors are consited of curative effect, medical cost, executive information and variation agents.We especially put more emphasis on clinical pathway group in Beijing about TCM pattern of syndrome and favor. With these data we also evaluate the regional disparity effect on clinical pathway.Result1Clinical curative effectAfter treatment with clinical pathway or non-clinical pathway, the main symptoms and secondary symptoms disappeare largely (P<0.05or P<0.01). After one month with no treatmen, the accumulated points of clinical pathway group still decrease but it make no sense (P>0.05) when contrast with the accumulated points after treatment. The accumulated points of non-clinical pathway group increased greatly (P<0.01) when contrast with the accumulated points after treatment and clinical pathway group. So the curative effect of clinical pathway group is better than that of non-clinical pathway group(P<0.01). And the result is same even after1month,3monthes and1year when contrast with the desensitization group(P<0.01). 2Medical costThe medical cost of clinical pathway group and western medicine group is greatly lower than the desensitization group(P<0.05)and so it is with the cost of examination.In clinical pathway group the cost of Chinese crude drug is higher than feature heath care cost (P<0.01).2The pattern of syndromeIn our study we find out that most patients are belonged to deficiency-weakness of spleen-QI, then insufficieny of lung-QI, latent pyrexia of lung meridian. The least is the pattern of insufficiency of kidney yang. There is variance between the pattern of deficiency-weakness of spleen-QI and the pattern of insufficiency of kidney-yang. The pattern composition in Beijing is different with all the sample. Food hobby is clearly related with deficiency-weakness of spleen-QI, insufficieny of lung-QI and latent pyrexia of lung meridian.Most patients of deficiency-weakness of spleen-QI like smoking. Patients with eficiency-weakness of spleen-QI did not like cold drinks and snacks. Patients of latent pyrexia of lung meridian like spicy food better than wine4The TCM clinical pathway effectAll the patients in TCM clinical pathway of allergic rhinitis are treated with Chinese crude drug or Chinese formulated drugs, nasal drops. The percentage of patients treated wih one acupuncture is38.8%, two acupuncture treatment48.1%and three acupuncture treatment9.4%. The summary of acupuncture treatment is95.3%. It is composed of needling, spreading and moxibustion. When clinical pathway is applied to patients, feature treatments are used more widely and standardizedly.5The sign off of patientsOnly4patients in clinical pathway group give up.Two patients can not take oral Chinese medicine. The other two can not go on because of feature treatments6The curative effectAll the patients are satisfied with the manage expense, time of therapy and the diagnose and treatment service. They also expect they can see the doctor less time.Conclusion1The TCM clinical pathway of allergic rhinitis can not only cure typical symptom but also can improve patients substances. That is the reason why patients can still feel good even when they terminate treatment.2The cost of clinical pathway group is lower than desensitization group. With the same cost, the curative effect of clinical pathway group is better than western medicine group.3The region factor should be considered in clinical pathway. In Beijing we should suggest patients with less spicy food, no drinking and no smoking.4When clinical pathway is applied to patients.feature treatments are used more widely and standardizedly.5When clinical pathway is applied into practice, we should optimize based on patients requirements. Then we can use less cost and less time to help patients.