- 學位論文
非小細胞肺癌的中醫輔助治療之成本效果分析：系統性回顧與統合分析
Cost-effectiveness analysis of Traditional Chinese Medicine as a Complementary Treatment in non-small cell lung cancer：a systematic review and meta-analysis.
摘要
研究目的 肺癌在近年已是世界上發生率及死亡率最高的惡性腫瘤，而其中非小細胞肺癌在台灣約佔全部肺癌85%，且通常確診都已是末期，故本研究探討中醫介入治療的成本效果分析，以提供罹患非小細胞肺癌之病患臨床上除了常規西醫治療方法的額外選擇。 研究方法 探討中醫介入非小細胞肺癌的治療之成本、效果與成本效果比的分析，依照中醫關鍵字搜尋共六個電子資料庫，再依據系統性文獻回顧的程序篩選並以統合分析進行結果彙整：依據森林圖呈現結果指標，及漏斗圖、Kendall's tau和Egger’s regression評估publication bias。 研究結果 研究發現中醫介入非小細胞肺癌的治療中，在提高生活品質(Z=3.449,p-value=.001)、延長無病進展期(Z=2.382,p-value=.017)及總體存活時間(Z=3.477,p-value=.001)有顯著效果，依固體瘤評價標準也可顯著增加總體反應率(Odds ratio=1.605,p-value=.006)及疾病緩解率(Odds ratio=1.42,p-value=.001)，但在成本上並無顯著差異(Z=1.216,p-value=.001)，結果皆符合研究假說。 結論與建議 中醫介入非小細胞肺癌的治療對病患生活品質及生存期的延長都有不錯的效果，在治療成本上也與未介入沒有顯著差異，並期待本研究系統性回顧及統合分析後之證據，能提供臨床治療更普遍的應用與介入，相信對病患的治癒率及疾病發展都有正向幫助。
並列摘要
Objectives Lung cancer has been the most malignant tumor with the highest incidence and mortality in the world in recent years. Among them, non-small cell lung cancer(NSCLC) accounts for 85% in Taiwan, and confirmed diagnosis in advanced stage. Therefore, this study explores the cost effect of traditional Chinese medicine(TCM) interventional therapy. Analysis to provide additional options for clinically in addition to conventional Western medical treatment for patients with non-small cell lung cancer Materials and method To explore the cost, effect and cost-effectiveness ratio of TCM intervention in non-small cell lung cancer. Search for six electronic databases by the keyword contains " traditional Chinese", "Chinese medicine", "herbal medicine", "alternative", "complementary", and then screen according to the systematic review of the literature and analyze the results by integrative analysis. Results indicators based on forest plots, and funnel plots, Kendall's tau, and Egger’s regression assessment of publication bias Results The study found that TCM intervention in non-small cell lung cancer improved quality of life (Z=3.449, p-value=.001), prolonged progression-free survival (Z=2.382, p-value=.017) and overall survival time (Z= 3.477, p-value=.001) had a significant effect. And according to the solid tumor evaluation criteria, the overall response rate (Odds ratio=1.605, p-value=.006) and disease control rate (Odds ratio=1.42, p-value=. 0.001) were also significantly increased ,but there is no significant difference in cost (Z = 1.216, p-value = .001). The results are consistent with the research hypothesis which the intervention group was significantly better than the control group. Conclusion The intervention of TCM in the treatment of non-small cell lung cancer has a good effect on the quality of life and the prolongation of survival of patients. There was no significant difference in treatment costs from no intervention. Looking forward to the systematic review and evidence of the integrative analysis of this study, can provide more general application and intervention of clinical treatment. I believe that there will be positive help for the cure rate and disease development of patients.