摘要
目的基于社区干预模式,探讨爱睿康与多乐氟对低龄儿童乳牙龋病的预防效果及经济学效益。方法选取河池市宜州区儿童纳入研究并随机分为2组,爱睿康组和多乐氟组。分别使用相应含氟涂料,每6个月进行口腔健康教育+局部涂氟。1.5年后对比2组儿童干预前后龋病发生和成本支出情况,采用成本最小化分析法对二者的经济效益进行比较,通过敏感性分析来探讨模型中主要参数变化对研究结果稳定性的影响及量化分析2种含氟涂料在同等防龋效果下的成本优势概率差异。结果干预前2组间患龋率及龋均差异无统计学意义(P>0.05)。干预1.5年后2组间患龋率及龋均差异仍无统计学意义(P>0.05),龋病发病率和新增龋均差异也无统计学意义(P>0.05)。2组新增龋均差异的单侧97.5%CI均低于非劣效界值,非劣效性结论成立(P<0.025)。成本最小化分析结果显示,爱睿康组总成本(25411.44元)低于多乐氟组(26692.98元)。单因素敏感性分析中发现影响总成本的最主要参数是两者材料价格。通过1000次的蒙特卡罗模拟分析发现爱睿康组的总体费用低于多乐氟组的概率达到73.1%。结论爱睿康的防龋效果不劣于多乐氟,且爱睿康对减轻患者经济负担更具优势。
Objective A community intervention model was used to investigate the preventive effects and cost-effectiveness of I-ReHealth^(R)and Duraphat^(R)in early childhood caries.Methods Children from Yizhou District,Hechi City,were enrolled and randomly assigned into two groups:the I-ReHealth^(R)group and the Duraphat group.Each group received topical fluoride varnish applications and dental health education every 6 months.After 1.5 years,the incidence of caries and associated costs were compared between the two groups before and after the intervention.Cost minimization analysis was employed to evaluate economic efficiency,and sensitivity analysis was performed to assess the influence of variations in key parameters on result stability and to quantify the probabilistic differences in cost benefits between the two fluoride varnishes under equivalent caries-preventive effects.Results Prior to the intervention,we found no statistically significant differences in caries prevalence or mean dmft scores between the two groups(P>0.05).After 1.5 years of treatment,both groups still showed no statistically significant differences in caries prevalence(P>0.05),mean dmft scores(P>0.05),caries incidence rate(P>0.05),or increment in mean dmft(P>0.05).The one-sided 97.5%confidence interval for the difference in mean dmft increment was below the non-inferiority threshold,confirming non-inferiority(P<0.025).Cost minimization analysis revealed lower total costs in the I-ReHealth®group(¥25411.44)than in the Duraphat^(R)group(¥26692.98).One-way sensitivity analysis identified material price as the most influential parameter affecting total costs.Monte Carlo simulation with 1000 iterations demonstrated a 73.1%probability that the I-ReHealth^(R)group will yield cost savings compared with the Duraphat^(R)group.Conclusion I-Re‐Health^(R)is non-inferior to Duraphat^(R)in caries-preventive efficacy but superior in cost-effectiveness in reducing patient expenses.
作者
杨朝青
余锦梅
张艺山
刘芳宏
庞秋玲
谢羽璐
冉翎杉
邱荣敏
Yang Chaoqing;Yu Jinmei;Zhang Yishan;Liu Fanghong;Pang Qiuling;Xie Yulu;Ran Lingshan;Qiu Rongmin(College&Hospital of Stomatology,Guangxi Medical University,Guangxi Key Laboratory of the Rehabilitation and Reconstruction for Oral and Maxillofacial Research,Guangxi Clinical Research Center for Craniofacial Deformity,Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases,Nanning 530021,China;Dept.of Stomatology,The People's Hospital of Hechi,Hechi 547000,China)
出处
《华西口腔医学杂志》
北大核心
2026年第1期129-136,共8页
West China Journal of Stomatology
基金
广西科技厅重点研发项目(AB22035015)
广西医疗卫生适宜技术开发与推广应用项目(S2020041,S2024121)
南宁市青秀区科技计划项目-重点研发计划(2020039)
广西壮族自治区卫生健康委员会科研项目(Z-M20251725)。
关键词
低龄儿童龋
含氟涂料
社区干预
成本最小化分析
early childhood caries
fluoride varnish
community-based intervention
cost minimization analysis
