65歲以上老人抗病毒藥劑Tamiflu臨床效益分析探討-以高雄縣地區醫院為例

The research on the clinical curative effect analysis of antivirus drug Tamiflu in aged people- take one grade of hospitals of area of Kaohsjung county as an example

蘇芥慧(Chen-Hui Su)

指導教授 ： 詹道明

高雄醫學大學/藥學院/藥學研究所碩士在職專班/碩士(2006年)

摘要

本研究目的在探討醫院門診之類流感病患使用抗病毒藥劑Tamiflu後病患預後情形，作為臨床效益分析以提供行政院衛生署疾病管制局未來是否將抗病毒藥劑列入健保給付之參考及防疫工作上戰備藥品之準備。本研究對象乃選擇有使用Tamiflu的高雄縣二家地區級醫院（岡山鎮劉光雄醫院和林園鄉建佑醫院）之門診病患為研究對象，總計樣本數為209份。
針對受訪樣本使用藥物後緩解、治癒或病情惡化及副作用等就醫情形分析其藥物臨床效益。另也針對受訪樣本未使用藥物者，分析其特性因素、治療情形及預後情形。在本次研究中顯示，使用Tamiflu後之症狀預後評估，「急性發燒」預後痊癒比率為71.28%，其中實驗組痊癒率為84.48%，明顯高於對照組的50.00%(P<0.0005)。「咳嗽」預後，痊癒實驗組為56.44%，而對照組只有20.88%(P<0.0005)。「喉嚨痛」預後，痊癒實驗組為81.58%，對照組為30.30%(P<0.0005)。「肌肉酸痛」預後，痊癒實驗組為78.79%，而對照組為13.33%(P<0.0005)。「流鼻水」預後，痊癒實驗組為69.47%，對照組為29.87%(P<0.0005)。以上評估類流感病患之臨床症狀因使用Tamiflu而明顯受到改善，證實該藥物之療效頗佳。
另醫師對病患預後的滿意度從實驗組感到「滿意」有68.14%，「不如預期」僅15.04%。而對照組感到「滿意」有22.92%，「不滿意」則有30.21%，(P＜0.0005)顯示在統計學上有顯著的不同。

關鍵字

臨床效益 ； 痊癒率 ； 預後評估

並列摘要

This research in probe into purpose hospital clinic influenza patient use antivirus drug patient's prognosis situation under Tamiflu, control office of diseases of National Health Administration to the executive organ whether are listed the antivirus drug in and strong in protecting the reference paid and war preparedness medicines at work of epidemic prevention in the future in order to offer a control office of diseases of National Health Administration to the executive organ prepare. This research object is to choose to have two areas and one grade of hospitals of Kaohsjung county that use Tamiflu The out patient that (Kuang Hsiung Liu of Okayama Town and wooden land township Chine Yu hospital ) is the research object, it is 209 that the total sample is counted .
Analysis their clinical benefits of medicine in situation that the sample uses alleviating , curing or condition worsenning and side effect ,etc. after medicines and seeks medical advice to interviewing. persons who have not another used medicines to the sample of interviewing too, analysis its characteristic factor , treat the situation and prognosis situation. Show in this research, the symptom prognosis after using Tamiflu is assessed, ' have a fever acute ' the rate is 71.28% that the prognosis heals, it is 84.48% to test a group of fully recovering rate among them , is obviously higher than 50.00% of the (P<0.0005). ' cough ' prognosis, the experiment group is 56.44% to fully recover, and contrast the group and have 20.88% of the (P<0.0005). ' have a sore throat ' prognosis, the experiment group is 81.58% to fully recover, it is 30.30% of the (P<0.0005). The prognosis that ' the muscle aches ', the experiment group is 78.79% to fully recover, and it is 13.33% of the (P<0.0005). ' flow nose water ', prognosis, fully recover experiment group 69.47%, it is 29.87% of the (P<0.0005). The clinical symptom of the above assessing type influenza patient is being improved obviously because of using Tamiflu, the curative effect which verifies this medicine is quite good.
The group feels ' satisfied with ' from the experiment another doctor's satisfaction to patient's prognosis that there is 68.14%, not only 15.04% ' as expectancy '. And contrast the group feel ' satisfied ' there is 22.92%, ' unsatisfied ' have 30.21%, (P<0.0005) show that there is apparent difference in statistics.

並列關鍵字

Clinical benefit ； fully recovering rate ； prognosis assessing

參考文獻

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