[Cost-effectiveness analysis of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in treatment of chronic rhinosinusitis].

This study aims to evaluate the effectiveness and economic efficiency of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of chronic rhinosinusitis(CRS). The randomized controlled trial(RCT) of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS was searched against EMbase, PubMed, Cochrane Library, CNKI, VIP, SinoMed, and Wanfang. The efficacy, nasal mucociliary transport time, and safety of the therapy above in the treatment of CRS were analyzed with single-group rate and Meta-analysis, and the economy and sensitivity were evaluated from the perspective of payer. A total of 9 RCTs were included, including 1 145 patients. Meta-analysis showed that compared with Triamcinolone Acetonide Nasal Spray alone, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS patients increased the effective rate(RR=1.17, 95%CI[1.11, 1.24], P<0.000 01) and shortened the nasal mucociliary transport time(MD=-3.32, 95%CI[-5.86,-0.78], P=0.01), there was no significant difference in the incidence of adverse reactions between the two groups. The incremental cost-effectiveness analysis showed that the treatment costs of the control group and the observation group were 44.15 yuan and 1 044.96 yuan, respectively. In the Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray treatment group, 75.48 yuan was spent to improve the effective rate of CRS by 1%. The one-way sensitivity analysis indicated the days of treatment, the RR of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray, the price of unit preparation of Biyuan Tongqiao Granules, and the effective rate of Triamcinolone Acetonide Nasal Spray alone had great influence on the incremental cost-effectiveness ratio. In conclusion, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray improves the therapeutic effect on CRS. The probabilistic sensitivity analysis showed that when the willingness to pay was greater than 7 920 yuan(less than 0.1 of GDP per capita 8 098 yuan), the combined therapy was economically superior to the control. Due to the limited number of articles published, it is necessary to carry out a real-world clinical trial of Biyuan Tongqiao Gra-nules and Triamcinolone Acetonide Nasal Spray in the treatment of CRS, so as to compare the cost-effectiveness of Biyuan Tongqiao Granules and Triamcinolone Acetonide Nasal Spray.

[The protective effect of Rhadiola Astragalus Codonopsis compound on myocardium in early stage of severe burn at plateau in rats].

OBJECTIVE: To investigate the severity of early myocardial injury in rats with 30% full thickness burn at plateau and the protective effects of Rhadiola Astragalus Codonopsis Compound (RACC) on the rat myocardial injury. METHODS: One hundred and four Wistar rats with 30% full thickness burn were randomly divided into RACC application (R, n = 48) and scalding group 1 (S, n = 48), and another 8 healthy Wistar rats as control group 2 (C, n = 8). Four ml of RACC was garaged into the rat stomach in R and 4 ml isotonic saline in S groups respectively, but no treatment in C group. Blood samples from the aorta were harvested in 3, 6, 12, 24, 48 and 72 postburn hours (PBH) for blood gas analysis and for the determination of the changes in myocardial enzymes. Rat heart was harvested for pathomorphological examination. RESULTS: The rat myocardial tissue injury in R and S groups was obvious at 3 PBH and ameliorated gradually thereafter, up to the degree in C group at 72 PBH. The serum levels of myocardial enzymes in R and S groups were significantly higher than those in C group (P < 0.01). Whereas the enzymes in R group were much lower than those in S group (P < 0.01). It was indicated by blood gas analysis that the pH in R and S groups was lower than that in C group (P < 0.05), while that in R group at 12 - 24 PBH was higher than that in S group (P < 0.05). In addition, the base excess in R and S groups was lower than that in C group (P < 0.01), while that in R group at 6 PBH was higher than that in S group (P < 0.05 approximately 0.01). The PaCO2 in R and S groups was evidently lower than that in C group (P < 0.05 approximately 0.01), while that in R group at 48 PBH was no different to that in C group (35.70 +/- 4.23 mmHg vs 37.50 +/- 6.53 mmHg, P > 0.05). The PaO2 in R and S groups at 3 approximately 24 PBH was higher than that in C group and decreased gradually (P > 0.05). There was no difference in SaO2 among 3 groups (P > 0.05). CONCLUSION: RACC exhibited beneficial to the protection of rat heart from myocardial injury at plateau induced by severe burn.