A Clinical Research And Cost-effectiveness Analysis Concerning The Applying Of Capsules Of Dredging Collaterals&Reinforcing The Kidney As A Therapy To Patients With Diabetic Nephropathy

Purpose:Through observing the Clinical effect and the improvement of living quality etc. in the application of the Capsules of Dredging Collaterals&Reinforcing the Kidney to patients suffering from Diabetic nephropathy (DN) in the Ⅲ,Ⅳ phase of illness development, the author evaluates the comprehensive therapeutic effect of this kind of medicine for DN patients; meanwhile, the author also makes health economics evaluation of this intervention by means of cost-and-effectiveness analytical approach, for the purpose of offering reference to the good clinical treatment and sensible allocation of health resources from perspectives of clinical effect as well as health economics.Method:The author selects patients suffering from DN in the Ⅲ,Ⅳ phase of illness development according to clinical diagnosis, and those who accord to the case history in the order of records. All of them are divided into two groups at random---treatment group and matched group---with70patients each. In addition to the basic treatment, patients in the treatment group take Capsules of Dredging Collaterals&Reinforcing the Kidney, while patients in the matched group take the capsules of Qishu. The observation lasts six months with an interview conducted among the patients every one month. The curative effect of proteinuria and clinical symptoms are the emphasis for observation; the patients’ ratings of life quality are recorded; the cost of treatment and the cost-effectiveness ratio will be calculated.Results:1. the evaluation of curative effect By comparison of urinary protein of the treatment group with the matched group, the author gets the total effective rate---the treatment group60.0%, while the matched group31.4%---the difference has statistical significance (P<0.05); the comparison results of curative effect of clinical symptoms indicates the total effective rate of the treatment group is57.1%, while that of the matched group is31.4%; the difference has statistical significance (P<0.05); the comprehensive therapeutic effect shows that the total effective rate of the treatment group is50.0%, while that of the matched group is25.7%; the difference has statistical significance (P<0.05)2. the observation for index of curative effectComparison of the excretion rate of urine microalbumin for the two groups in different periods of time is made through repeated measure analysis of variance, which shows remarkable reciprocal action (F=22.078, P<0.001). The slippage of the excretion rate of urine microalbumin during the period of the last six-month treatment has statistical difference (t=3.039, P=0.003); the comparison of the two groups’24-hour urinary protein quantity during different periods of time shows remarkable reciprocal action (F=3.503, P<0.001) through repeated measure analysis of variance. Besides, the slippage of the excretion rate of urine microalbumin during the period of the last six-month treatment has statistical difference (t=0.986, P=0.049).For the comparison of the Integration of TCM clinic symptoms for the two groups of patients in different periods of treatment, the author adopts repeated measure analysis of variance and indicates remarkable reciprocal action (F=26.595, P<0.001). Moreover, the slippage of the integration of TCM clinic symptoms during the period of the last six-month treatment has statistical difference (t=5.397, P=0.001)3. the analysis of the patients’ quality of lifeAs for the comparison of the integration of life quality universality for the two groups of patients in different periods of treatment, the author adopts repeated measure analysis of variance and indicates the difference of the two groups has statistical difference (F=4.522,P=0.035), and it has remarkable reciprocal action (F=46.588, P<0.001). Moreover, the added Integration value of the universal life quality during the period of the last six-month treatment has statistical difference (t=6.202, P=0.001); As for the comparison of the diabetes-specific quality of life integration for the two groups of patients in different periods of treatment, the author still adopts repeated measure variance analysis which indicates that it has remarkable reciprocal action (F=67.616, P<0.001). Besides, the added value of the diabetes-specific quality of life for the two groups during the period of the last six-month treatment has statistical difference (t=0.034, P=0.001).4. the evaluation of health economicsThe direct cost of the treatment group is higher than that of the matched group (P<0.05), however, the treatment group cost less than the matched group by comparison of the ratio of cost-effectiveness analysis.Conclusion:As for the total effective rate, the treatment of the Capsules of Dredging Collaterals&Reinforcing the Kidney is superior to the Capsules of Qishu, and the former can relieve the clinical symptom of the patients, improve their life quality. Furthermore, by cost-effectiveness analysis, cost-effectiveness ratio of treatment group is evidently lower than that of the matched group. So Applying of Capsules of Dredging Collaterals&Reinforcing the Kidney as a Therapy to Patients with Diabetic Nephropathy is both effective and economical.