Clinical Observation And Cost - Effectiveness Analysis Of Acupuncture Plus Acupoint - Pressing Method For Cessation Of Smoking Addiction

This papr is divided into two parts of literature review and clinical research.1. Literature Review:The first part includes that the ancient literature mainly elaborated the cognition of the disease, etiology and pathogenesis, as well as clinical manifestations and acupuncture therapy.The modern literature includes two aspects of syndrome differentiation and clinic treatment. Western medicine literature includs two parts of pathogenic factors and therapies. And the second part includes analyzing the current status of the application of health economics analysis in acupuncture researches.2. Clinical Research:Objective:Through the comparement between the treatments of acupuncture combining with auricular seed-pressing and the treatment of nicotine patch for patients with tobacco addiction by Cost-Effectiveness Analysis (CEA).Methods:1. Clinical:Allocated 60 patients with sciatica due to smoking into two groups: acupuncture+ auricular seed-press ing group (Group A),nicotine patch group (Group B)randomized centrally.Treatmentcourse was eight weeks. Evaluated the clinical effect in week 1、week 2、week 4、week 8 an follow-up time by the smoking cessation rate、Fagerstrom Test of Nicotine Dependence (FTND) and Heavy Smoking Index (HSI)2. Health economic evaluation: Compared the smoking cessation rate、FTND and HSI results with cost to acquire the Cost-Effectiveness Ratio(CER).Results:1. Results of therapeutic evaluation:Base line was consistent. After eight weeks treatment, FTND and HSI scores of 60 patients treated by two therapies were all decreased significantly (P< 0.01) and associated with time effect. But scores among two groups on different time had no significant difference(P>0.05). In the other hand,the smoking cessation rate were all increased.But scores among two groups on different time had no significant difference(P >0.05).2. Results of Health economic evaluation:(1)Total Cost:At the end of the trial, the total cost of group A and B were ￥1867.3、￥2204.4 respectively, which had significant difference (P<0.01). As the condition of therapeutic evaluation results showed no difference between two groups,cost-minimization analysis (CMA) could be applied in health economic evaluation. Group A is lowest by CMA.(2)Cost-effectiveness Analysis:At the end of the trial, cost decrease for two groups were ￥384.09、￥522.37 when FTND decreased 1 point. Reduction of CER for HSI of two groups were ￥482.49/point、 ￥699.97/point.The cost increase for two groups were ￥50.59、￥49.00 when the smoking cessation rate increase 1%. These results demonstrated that group A is the lowest by CEA.Conclus ion:1. Acupuncture+ auricular seed-pressing and nicotine patch treatments have the same efficacy on reduce smoking desire.2. The total cost of the acupuncture+ auricular seed-pressing treatment is lower than the nicotine patch treatment,as well as CEA and CMA of the Acupuncture+ auricular seed-pressing treatment is more optimal.