目的 評價(jià)中醫(yī)藥不同時(shí)期干預(yù)治療冠心病慢性穩(wěn)定性心絞痛的成本-效果。方法 采集于2019年1月1日—12月31日北京市26家公立醫(yī)院HIS中的冠心病慢性穩(wěn)定性心絞痛患者數(shù)據(jù)，根據(jù)不同的治療方案，設(shè)對照組和試驗(yàn)組。對照組為西醫(yī)基礎(chǔ)治療，試驗(yàn)組在西醫(yī)治療基礎(chǔ)上加任一種中醫(yī)治療方式（中藥治療或中醫(yī)外治法）。試驗(yàn)組再按照中醫(yī)藥干預(yù)的時(shí)間節(jié)點(diǎn)分為中醫(yī)藥前期、中期、后期干預(yù)各組，對照組納入患者32例，試驗(yàn)組共納入患者177例，其中前期干預(yù)96例，中期干預(yù)44例，后期干預(yù)37例。采用傾向性得分匹配（PSM）平衡各組例數(shù)，并比較對照組與其他3組的臨床療效和成本，在此基礎(chǔ)上進(jìn)行成本-效果分析。結(jié)果 PSM匹配后前期、中期、后期干預(yù)組的臨床總有效率均為100%，匹配的對照組的總有效率分別為93.75%、90.91%、93.75%。PSM后，中醫(yī)藥前期、中期、后期干預(yù)組的平均治療費(fèi)用分別為14 752.51、12 684.28、16 226.96元，平均住院時(shí)間分別為9.81、11.56、8.91 d；匹配后對照組平均治療費(fèi)用分別為8 907.98、7 420.56、8 740.09元，平均住院時(shí)間分別為5.88、6.27、5.69 d。各組治療費(fèi)用中以中醫(yī)藥后期干預(yù)組成本最高，以對照組成本最低。中醫(yī)藥前期、中期、后期干預(yù)的平均成本-效果比（C/E）分別為147.53、126.84、162.27。相較各自匹配的對照組，中醫(yī)藥前期、中期、后期干預(yù)組的增量成本-效果比（ICER）分別為935.12、579.07、1 197.90。結(jié)論 相較前期與后期干預(yù)，中醫(yī)藥中期干預(yù)ICER最低，其成本-效果在中醫(yī)藥各干預(yù)階段中最具優(yōu)勢。

Objective To evaluate the cost-effectiveness of traditional Chinese medicine intervention in treatment of chronic stable angina pectoris in coronary heart disease at different stages. Method Data of patients with chronic stable angina pectoris caused by coronary heart disease were collected from 26 public hospitals in Beijing from January 1 to December 31, 2019. According to different treatment plans, a control group and an experimental group were set up. The control group received basic Western medicine treatment, while the experimental group received either traditional Chinese medicine treatment or external treatment based on Western medicine treatment. The experimental group was further divided into pre-intervention, mid-intervention, and postintervention groups based on the time nodes of traditional Chinese medicine intervention. The control group included 32 patients, and the experimental group included a total of 177 patients, including 96 pre-intervention cases, 44 mid-intervention cases, and 37 post-intervention cases. Using propensity score matching (PSM) to balance the number of cases in each group, and comparing the clinical efficacy and cost between the control group and the other three groups, a cost-effectiveness analysis was conducted on this basis. Results The total clinical effective rates of pre-intervention, mid-intervention, and post-intervention group after PSM matching were all 100%, while the total effective rates of the matched control group were 93.75%, 90.91%, and 93.75%, respectively. After PSM, the average treatment costs for pre-intervention, mid-intervention, and post-intervention group were 14 752.51 yuan, 12 684.28 yuan, and 16 226.96 yuan, respectively, with an average hospital stay of 9.81 days, 11.56 days, and 8.91 days. After matching, the average treatment costs of the control group were 8 907.98 yuan, 7 420.56 yuan, and 8 740.09 yuan, respectively, and the average hospitalization time was 5.88 days, 6.27 days, and 5.69 days, respectively. Among the treatment costs of each group, the post-intervention group with traditional Chinese medicine had the highest cost, while the control group had the lowest cost. The average cost-effectiveness ratio (C/E) of pre-intervention, mid-intervention, and post-intervention group were 147.53, 126.84, and 162.27, respectively. Compared to the matched control groups, the incremental cost-effectiveness ratios (ICER) of pre-intervention, mid-intervention, and post-intervention group were 935.12, 579.07, and 1197.90, respectively. Conclusion Compared with pre-intervention, the mid-term intervention of traditional Chinese medicine (TCM) has the lowest ICER, and its costeffectiveness is the most advantageous among all intervention stages of TCM.

R979.1

國家中醫(yī)藥管理局中醫(yī)藥總費(fèi)用核算及政策分析（GZY-GCS-2019-026）