| 摘要: | 一、目的： 1、監督各計劃之進行及使子計畫順利進行 2、使計畫執行者接受教育訓練更謹慎的執行臨床試驗 3、同時本研究針對中西醫合診的病患，進行療效評估，並進一步評估是否具有成本效果， 以作為未來推行計畫及研究者的參考依據。 二、實施方法 本計畫為中西醫合診療效之分析，分別對腦性麻痺及小兒氣喘進行生活品質之探討，再對中西醫合診成本效益做近一步研究。同時本計畫底下還有一項子計畫，其執行內容大致如下： 子計畫：台灣地區腦性麻痺患兒中醫整體治療臨床療效評估 ◎ 執行方法—12歲以前之腦癱患兒接受整體中醫療法，對照組不同處僅在未接受中醫整體 治療，但是其他治療仍繼續，實驗組為加入中醫整體治療治療。 為使中醫師能夠更了解在執行中西醫合診應注意那些事項，以及臨床量表之使用，同時也為了讓中醫師了解在醫療成本上該如何去評估執行中西醫合診是否符合經濟本效益，將不定期舉辦教育訓練課程。成本效益評估本研究主要針對小兒腦性麻痺、小兒氣喘二種疾病，接受中西醫合診的病患進行生活品質探討，並進一步評估是否具有成本效果，以作為未來推行計畫及研究者的參考依據。 研究對象則是針對特定疾病前來就醫的患者，依照就診的類型區分標準。每一種疾病之實驗設計均分為實驗組及對照組，實驗組為採用中西醫合診治療的病患，對照組則為僅採用西醫治療的患者。 病患於收案後即進行前測評估，本研究將針對不同之疾病患者施行生活品質量表(Short Form-36,SF-36)之評估；而經過醫師評定，認定該患者已滿足後測所需條件之後，即施行後測評估。 在成本評估方面，包括醫療機構所需花費之成本(包含直接成本如人力、藥品衛材、醫療設備，及間接成本如作業費用、行政管理等成本)，因此，在效益評估方面，將品質調整生命年作為本研究之效益評估，QALYs計算則是利用存活率及生活品質來衡量。 透過本研究，可以了解中西醫合診對患者在臨床上的成效，以及在臨床應用上是否具有成本效果，研究結果可以作為醫師及管理者在選擇中西醫合診與西醫治療上的參考依據。
Objective: 1.To supervise each plan and make the sub plan go on smoothly 2.To make planning executors accept education and training which have more prudent execution on clinical testing. This plan is a one-year plan, the ones that take charge of supervising four following plans to go on,respectively, Sub-plan I :The Impact of the intergration of Chinese and medicine on cerebral palsy in Taiwan administration: We will collect CP children below 12years old to receive this complex Traditional Chinese medicine ,under observation of Gross Motor Function Measure（GMFM），Chinese Children Developmental Inventory (CCDI)，Short form 36 (SF36) after 3-month treatment, under the rule of randomized control. Sub-plan II: The set-up of standard protocol of traditional Chinese medicine in treatment of CVA patients and evaluation of clinical efficacy administration: Contrasting group's experimental design of distribution that this research adopts the will of treating and leads, experiment group (to care with Western medicine and Chinese medicine ) 40 people contrast group (simple Western medicine is cared) 40 people of the one equal to experiment group of weight of condition, Chinese medicine is handled and included traditional Chinese medicine, acupuncture and moxibustion and traumatology's handling etc., and assess the patient's neurology and function state while and leave hospital before treatinging. Sub-plan III: The clinical pathway and clinical efficacy evaluation of children athma ◎ administration: Forty of asthmatic children with age of 6-15 years old and positive for mite-specific IgE will be enrolled in this study. The patients will be divided into 2 groups, one is the western drug group, the other will receive 「standard flow chart of athma expertise OPD」 for 3 months. The efficacy will be evaluated with quality of life, their daily symptom score, medication score, morning and evening PEFRs. Sub-plan IV:Measuring the cost-effectiveness and health-related Quality of life for Chinese western combine therapy. administration: The patient examines the assessment before going on promptly after the accepting case, this research will implement the quality form of the life product to different disease people person (Short Form-36, assessment that SF-36 ); And evaluate through the doctor , after asserting that this patient examines the necessary condition after already meeting, namely examine assessing after implementing . In order to make all plans go on smoothly, under the general command centre , set up supervision , education and coordination three groups. It wields and responsible for the item as follows: 1、Supervision group: Responsible for supervising every sub planning to carry out the progress, in order to enable sub plan to finish on time. Hold the progress meeting one month before the plan begins by the general command centre, reach a common consensus with each plan director and reach an agreement to scheduled the progress to reach; After the plan begins, it will supervise work every three months, sending the documents by the assistant to notice and hand in the progress, the personnel of command centre will responsible for censorship work. 2、Educational group: In order to enable researcher clearly to know what a research must be paid attention to, the educational group is established, take charge of arranging education and training class. To be aimed at the operational staff, the command centre will arrange related education training program. 3、Coordination group: Carry out plan may run into bottleneck more or less , coordination group set up by command centre commissioner responsible for, by telephone, E-mail, letter ,etc., collects the coordination suggestion of each plan, and deal with promptly at once when taking over case in three weeks, In order to enable plan to go on smoothly. |
