Clinical and Economic Evaluation of Acupuncture for Opioid-Dependent Patients Receiving Methadone Maintenance Treatment: The Integrative Clinical Trial and Evidence-Based Data.
Clinical and Economic Evaluation of Acupuncture for Opioid-Dependent Patients Receiving Methadone Maintenance Treatment: The Integrative Clinical Trial and Evidence-Based Data.
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针灸对接受美沙酮维持治疗的阿片类药物依赖患者的临床和经济评价：综合临床试验和循证数据
DOI：
10.3389/fpubh.2021.689753
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发表时间：
2021
影响因子：
5.2
通讯作者：
Lu L
中科院分区：
文献类型：
--
作者：
Wen H;Wei X;Ge S;Zeng J;Luo W;Chen R;Dong Y;Xiao S;Lai Y;Lu L
目的：本研究旨在从医疗保健和社会角度评估针灸作为辅助治疗对接受美沙酮维持治疗（MMT）患者的临床和经济效果。方法：我们于2019年在中国进行了一项平行组随机对照试验。纳入符合诊断标准并接受MMT超过30天的患者。患者按 1:1 的比例随机分配至暴露组（针灸加 MMT）或对照组（MMT）。选择每日美沙酮剂量、使用VAS评分的药物渴望以及使用匹兹堡睡眠质量指数（PSQI）的失眠作为有效性指标，并选择质量调整生命年（QALY）作为效用指标。结果：总共纳入 123 名患者。暴露组在每日美沙酮剂量（17.68 vs. 1.07）、VAS（38.27 vs. 2.64）和PSQI（2.18 vs. 0.30）的改善方面均显着（P < 0.05）优于对照组。暴露组的 QALY 为 0.0784 (95% CI: 0.0761–0.0808)，对照组为 0.0762 (95% CI: 0.0738–0.0787)。暴露组的总费用（2869.50元）高于对照组（2186.04元）。每日美沙酮剂量的 ICER（41.15）、VAS（17.86）和 PSQI（313.51）被证明具有经济效率。而 ICUR（310,663.64 元/QYLY）高于 WHO 建议的费用。结论:针灸作为MMT患者的辅助治疗,通过减少美沙酮用量、改善药物渴望、缓解失眠等实现了成本效益。它有助于提高生活质量，但由于其成本超出了社会愿意支付的水平，因此需要进一步研究。
Objective: From the health care and societal perspectives, this study aimed to evaluate the clinical and economic effects of acupuncture as an adjunctive therapy for patients receiving methadone maintenance treatment (MMT). Methods: We conducted a parallel-arm RCT in China in 2019. Patients were included who met the diagnostic criteria and receive MMT for more than 30 days. Patients were randomly assigned to the exposed group (acupuncture plus MMT) or control group (MMT) at a 1:1 ratio. Daily methadone dosage, drug cravings using the VAS score, and insomnia using the Pittsburgh Sleep Quality Index (PSQI) were chosen as the effectiveness indexes, and the quality-adjusted life years (QALYs) was chosen as the utility index. Results: Overall, 123 patients were included. The exposed group was significantly (P < 0.05) better than the control group in the improvement of daily methadone dosage (17.68 vs. 1.07), VAS (38.27 vs. 2.64), and PSQI (2.18 vs. 0.30). The QALY was 0.0784 (95%CI: 0.0761–0.0808) for the exposed group and 0.0762 (95%CI: 0.0738–0.0787) for the control group. The total cost of the exposed group (2869.50 CNY) was higher than the control group (2186.04 CNY). The ICER of daily methadone dosage (41.15), VAS (17.86), and PSQI (313.51) were shown to be economically efficient. While ICUR (310,663.64 CNY/QYLY) was higher than the cost suggested by WHO. Conclusion: Acupuncture as an adjuvant therapy for MMT patients realizes its cost-effectiveness by reducing the dosage of methadone, improving drug cravings, and alleviating insomnia. It helps to improve quality of life, but since its cost exceeds what society is willing to pay, further study is needed.
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影响因子：
--
作者：
Kim, YS;Jun, H;Chae, Y;Park, HJ;Kim, BH;Chang, IM;Kang, SK;Lee, HJ
通讯作者：
Lee, HJ
影响因子：
3
作者：
Larochelle MR;Wakeman SE;Ameli O;Chaisson CE;McPheeters JT;Crown WH;Azocar F;Sanghavi DM
通讯作者：
Sanghavi DM
影响因子：
2.9
作者：
Jiang Ying-ping;Liu Hao;Lu Guang-hua
通讯作者：
Lu Guang-hua
DOI：
10.3760/cma.j.issn.0254-6450.2018.05.016
发表时间：
2018-05-10
影响因子：
--
作者：
Cheng, Z;Chen, G H;Cao, X B
通讯作者：
Cao, X B
DOI：
10.1155/2013/134610
发表时间：
2013
期刊：
Evidence-based complementary and alternative medicine : eCAM
影响因子：
--
作者：
Chen YH;Ivanic B;Chuang CM;Lu DY;Lin JG
通讯作者：
Lin JG